Jelle C L Himmelreich1, Evert P M Karregat2, Wim A M Lucassen2, Henk C P M van Weert2, Joris R de Groot3, M Louis Handoko4, Robin Nijveldt5, Ralf E Harskamp2. 1. Amsterdam UMC, University of Amsterdam, Department of General Practice, Amsterdam Public Health, Amsterdam, The Netherlands j.c.himmelreich@amc.uva.nl. 2. Amsterdam UMC, University of Amsterdam, Department of General Practice, Amsterdam Public Health, Amsterdam, The Netherlands. 3. Amsterdam UMC, University of Amsterdam, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands. 4. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands. 5. Radboud University Medical Center, Department of Cardiology, Nijmegen, The Netherlands.
Abstract
PURPOSE: To validate a smartphone-operated, single-lead electrocardiography (1L-ECG) device (AliveCor KardiaMobile) with an integrated algorithm for atrial fibrillation (AF) against 12-lead ECG (12L-ECG) in a primary care population. METHODS: We recruited consecutive patients who underwent 12L-ECG for any nonacute indication. Patients held a smartphone with connected 1L-ECG while local personnel simultaneously performed 12L-ECG. All 1L-ECG recordings were assessed by blinded cardiologists as well as by the smartphone-integrated algorithm. The study cardiologists also assessed all 12L-recordings in random order as the reference standard. We determined the diagnostic accuracy of the 1L-ECG in detecting AF or atrial flutter (AFL) as well as any rhythm abnormality and any conduction abnormality with the simultaneously performed 12L-ECG as the reference standard. RESULTS: We included 214 patients from 10 Dutch general practices. Mean ± SD age was 64.1 ± 14.7 years, and 53.7% of the patients were male. The 12L-ECG diagnosed AF/AFL, any rhythm abnormality, and any conduction abnormality in 23, 44, and 28 patients, respectively. The 1L-ECG as assessed by cardiologists had a sensitivity and specificity for AF/AFL of 100% (95% CI, 85.2%-100%) and 100% (95% CI, 98.1%-100%). The AF detection algorithm had a sensitivity and specificity of 87.0% (95% CI, 66.4%-97.2%) and 97.9% (95% CI, 94.7%-99.4%). The 1L-ECG as assessed by cardiologists had a sensitivity and specificity for any rhythm abnormality of 90.9% (95% CI, 78.3%-97.5%) and 93.5% (95% CI, 88.7%-96.7%) and for any conduction abnormality of 46.4% (95% CI, 27.5%-66.1%) and 100% (95% CI, 98.0%-100%). CONCLUSIONS: In a primary care population, a smartphone-operated, 1L-ECG device showed excellent diagnostic accuracy for AF/AFL and good diagnostic accuracy for other rhythm abnormalities. The 1L-ECG device was less sensitive for conduction abnormalities.
PURPOSE: To validate a smartphone-operated, single-lead electrocardiography (1L-ECG) device (AliveCor KardiaMobile) with an integrated algorithm for atrial fibrillation (AF) against 12-lead ECG (12L-ECG) in a primary care population. METHODS: We recruited consecutive patients who underwent 12L-ECG for any nonacute indication. Patients held a smartphone with connected 1L-ECG while local personnel simultaneously performed 12L-ECG. All 1L-ECG recordings were assessed by blinded cardiologists as well as by the smartphone-integrated algorithm. The study cardiologists also assessed all 12L-recordings in random order as the reference standard. We determined the diagnostic accuracy of the 1L-ECG in detecting AF or atrial flutter (AFL) as well as any rhythm abnormality and any conduction abnormality with the simultaneously performed 12L-ECG as the reference standard. RESULTS: We included 214 patients from 10 Dutch general practices. Mean ± SD age was 64.1 ± 14.7 years, and 53.7% of the patients were male. The 12L-ECG diagnosed AF/AFL, any rhythm abnormality, and any conduction abnormality in 23, 44, and 28 patients, respectively. The 1L-ECG as assessed by cardiologists had a sensitivity and specificity for AF/AFL of 100% (95% CI, 85.2%-100%) and 100% (95% CI, 98.1%-100%). The AF detection algorithm had a sensitivity and specificity of 87.0% (95% CI, 66.4%-97.2%) and 97.9% (95% CI, 94.7%-99.4%). The 1L-ECG as assessed by cardiologists had a sensitivity and specificity for any rhythm abnormality of 90.9% (95% CI, 78.3%-97.5%) and 93.5% (95% CI, 88.7%-96.7%) and for any conduction abnormality of 46.4% (95% CI, 27.5%-66.1%) and 100% (95% CI, 98.0%-100%). CONCLUSIONS: In a primary care population, a smartphone-operated, 1L-ECG device showed excellent diagnostic accuracy for AF/AFL and good diagnostic accuracy for other rhythm abnormalities. The 1L-ECG device was less sensitive for conduction abnormalities.
Authors: Nicole Lowres; Lis Neubeck; Glenn Salkeld; Ines Krass; Andrew J McLachlan; Julie Redfern; Alexandra A Bennett; Tom Briffa; Adrian Bauman; Carlos Martinez; Christopher Wallenhorst; Jerrett K Lau; David B Brieger; Raymond W Sy; S Ben Freedman Journal: Thromb Haemost Date: 2014-04-01 Impact factor: 5.249
Authors: Emmy Hoefman; Henk C P M van Weert; Johannes B Reitsma; Rudolph W Koster; Patrick J E Bindels Journal: Fam Pract Date: 2005-06-17 Impact factor: 2.267
Authors: Antonio Raviele; Franco Giada; Lennart Bergfeldt; Jean Jacques Blanc; Carina Blomstrom-Lundqvist; Lluis Mont; John M Morgan; M J Pekka Raatikainen; Gerhard Steinbeck; Sami Viskin; Paulus Kirchhof; Frieder Braunschweig; Martin Borggrefe; Meleze Hocini; Paolo Della Bella; Dipen Chandrakant Shah Journal: Europace Date: 2011-07 Impact factor: 5.214
Authors: Zachary C Haberman; Ryan T Jahn; Rupan Bose; Han Tun; Jerold S Shinbane; Rahul N Doshi; Philip M Chang; Leslie A Saxon Journal: J Cardiovasc Electrophysiol Date: 2015-03-19
Authors: Amila D William; Majd Kanbour; Thomas Callahan; Mandeep Bhargava; Niraj Varma; John Rickard; Walid Saliba; Kathy Wolski; Ayman Hussein; Bruce D Lindsay; Oussama M Wazni; Khaldoun G Tarakji Journal: Heart Rhythm Date: 2018-08-22 Impact factor: 6.343
Authors: Jari Halonen; Tero J Martikainen; Onni E Santala; Jukka A Lipponen; Helena Jäntti; Tuomas T Rissanen; Mika P Tarvainen; Tomi P Laitinen; Tiina M Laitinen; Maaret Castrén; Eemu-Samuli Väliaho; Olli A Rantula; Noora S Naukkarinen; Juha E K Hartikainen Journal: JMIR Cardio Date: 2022-06-21
Authors: Jonathan James Hyett Bray; Elin Fflur Lloyd; Firdaus Adenwalla; Sarah Kelly; Kathie Wareham; Julian P J Halcox Journal: BMJ Open Qual Date: 2021-03
Authors: Lisa Beers; Lisa P van Adrichem; Jelle C L Himmelreich; Evert P M Karregat; Jonas S S G de Jong; Pieter G Postema; Joris R de Groot; Wim A M Lucassen; Ralf E Harskamp Journal: BMJ Open Date: 2021-11-03 Impact factor: 2.692
Authors: Evert P M Karregat; Jelle C L Himmelreich; Wim A M Lucassen; Wim B Busschers; Henk C P M van Weert; Ralf E Harskamp Journal: Fam Pract Date: 2021-03-29 Impact factor: 2.267