Screening for arrhythmia with the new portable single-lead electrocardiographic device (SnapECG): an application...

SnapECG is a new handheld single-lead electrocardiograph (ECG) device used for arrhythmia screening, it is widely used in clinical practice but not in primary care.

To evaluate the arrhythmia screening value of SnapECG among a community-based population.

A cross-sectional community-based study of multistage stratified cluster sampling was conducted from March 1st to April 30th 2019. The sensitivities, specificities and the area under the receiver operating characteristic (AUC_ROC) curves of the SnapECG and reference 12-lead ECG on arrhythmia were calculated in three age-groups [50-64 years, 65-74 years, and over-75 years].

A total of 2263 participants took part in the arrhythmia screening, these included 1479 aged 50-64 years, 602 aged 65-74 years and 182 aged over-75 years. The SnapECG categorized 1828 (80.8%) as sinus rhythm, 161 (7.1%) as premature atrial/ventricular contractions (PAVs/PCVs), 32 (1.4%) as possible atrial fibrillation (AF), 56 (2.5%) as supraventricular tachycardias or sinus bradycardia (SVT/SB) and 186 (8.2%) as unreadable. SnapECG had 89% sensitivity (95% CI 0.52-1.00) and 99% specificity (95% CI 0.97-0.99) of detecting AF in the 65-74 years age-group. The AUC_ROC to detect AF was 0.94 for the 65-74 years age-group, 0.77 for over-75 years, 0.62 for the 50-64 years.

This study is the first community screening application of SnapECG. Main limitation is the SnapECG and the 12-lead ECG were not done simultaneously.

In the people aged 65-74 years, AF can be detected accurately by the SnapECG with high sensitivity, specificity and large area under the ROC curve, which might have the highest screening predictive accuracy.