Diagnostic accuracy of a smartphone-operated single-lead electrocardiogram

Performing a traditional electrocardiogram (ECG) in primary care can be cumbersome and is unavailable in some primary care practices. A new alternative–a handheld, smartphone-enabled 1-lead ECG–may provide physicians with a viable alternative for detecting cardiac arrhythmias in patients presenting with non-acute cardiac concerns in primary care. In a multi-center validation study of the device’s diagnostic accuracy, blinded cardiologists assessed data from 214 Dutch primary care patients collected simultaneously from the 1-lead and 12-lead devices. The handheld device showed excellent diagnostic accuracy, as cardiologists were able to detect all cases of atrial fibrillation and atrial flutter from the device’s readings. The study also compared expert review of the handheld device’s readings to the smartphone-integrated diagnostic algorithm’s interpretation of the device’s output. The algorithm correctly identified 87% of atrial fibrillation cases and 98% of non-atrial fibrillation cases. The algorithm was less accurate in categorizing other abnormalities. The smartphone-operated ECG may be a viable alternative for physicians in need of a point-of-care device to detect key arrhythmias in the preventive care of stroke.

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Diagnostic Accuracy of a Smartphone-operated Single-lead Electrocardiogram to Detect Rhythm and Conduction Abnormalities in Primary Care

Jelle C.L. Himmelreich, MD, MSc, et al

Amsterdam UMC, University of Amsterdam, Department of General Practice, The Netherlands