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Patient Directed Recording of a Bipolar Three-Lead Electrocardiogram using a Smartwatch with ECG Function
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Layman electrocardiographic screening using smartphone-based multiple‑lead ECG device in school children.
Niccolò Maurizi1, Carlo Fumagalli2, Ioannis Skalidis3
1Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy; Department of Cardiology, University Hospital of Lausanne, Switzerland.
International Journal of Cardiology
|December 13, 2022
Summary
Smartphone ECG screening is feasible for large populations, costing less than traditional methods. This technology offers a 19% cost saving, making it ideal for widespread pre-participation screening.
Area of Science:
- Cardiology
- Digital Health
- Public Health
Background:
- Pre-participation electrocardiogram (ECG) screening impacts socioeconomic factors.
- Advancements enable low-cost, high-tech ECG screening using smartphone-based devices.
- Laypersons can perform 12-lead ECGs with smartphone guidance, requiring no medical background.
Purpose of the Study:
- To assess the feasibility and effectiveness of smartphone-based 12-lead ECG screening in a large population of adolescents.
- To evaluate the cost-effectiveness of this novel screening method compared to traditional approaches.
- To determine the rate of interpretable ECGs and identify common findings and referral criteria.
Main Methods:
- 728 adolescents (12-13 years old) underwent smartphone 12-lead ECG screening during school hours.
- Layman volunteers performed ECGs, with electrode placement guided by a validated smartphone app image-processing algorithm.
- ECG interpretation was conducted via a telecardiology platform, classifying alterations according to current standards.
Main Results:
- Out of 741 recorded ECGs, only 13 (2%) were not interpretable.
- Common findings included T-wave inversion (21%) and incomplete right bundle branch block (4%).
- Referrals for second-level examination (3%) were due to deep Q-waves, ventricular ectopics, anterior T-wave inversions, or extreme right axis deviation, with no definitive diagnoses.
- The total project cost was €19.51 per individual, representing a 19% potential cost saving compared to current screening methods.
Conclusions:
- Smartphone-based 12-lead ECG screening by laypersons is feasible and effective, with a low rate of non-interpretable recordings (<5%).
- The method offers a significant potential cost saving of 19%, making it an attractive option for large-scale screening campaigns.
- This approach is particularly promising for implementation in developing countries or resource-limited settings.
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