New research suggests that a handheld, smartphone-enabled, single-lead electrocardiogram (ECG) device could provide physicians with a viable alternative to traditional ECGs to detect cardiac arrhythmias in patients presenting with non-acute cardiac concerns in primary care.
In a multi-centre validation study of the diagnostic accuracy of the one-lead device (KardiaMobile), blinded cardiologists assessed data from 214 Dutch primary care patients collected simultaneously from the one-lead device with an integrated algorithm for atrial fibrillation (AF) against a 12-lead device.
The 12-lead ECG diagnosed AF/atrial flutter (AFL), any rhythm abnormality and any conduction abnormality in 23, 44 and 28 patients, respectively.
The one-lead ECG, as assessed by cardiologists, had a sensitivity and specificity for AF/AFL of 100 per cent for both. The algorithm correctly identified 87 per cent of AF cases and 97.9 per cent of non-AF cases.
However, the one-lead ECG was less robust at categorising rhythm abnormality (sensitivity: 90.9%; specificity: 93.5%) and conduction abnormality (sensitivity: 46.4%; specificity: 100%).
“Our primary care-based study provides important insights for physicians who are in need of a point-of-care ECG device that can lower the logistical threshold for performing ECG to improve diagnostic gain,” the authors said. The findings are published in the Annals of Family Medicine.