Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress...

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Wearable wireless electrocardiographic (ECG) monitoring is established for arrhythmia detection.
• The accuracy of ECG for ischemia detection, particularly with single-lead devices, is less understood.
• Assessing ST-segment deviation agreement between single- and 12-lead ECG is crucial for clinical application.

Purpose of the Study:

• To evaluate the agreement of ST-segment deviation between single-lead and 12-lead ECG.
• To determine the accuracy of both ECG methods for detecting reversible myocardial ischemia.

Main Methods:

• Calculated bias and limits of agreement for ST-segment deviations between single- and 12-lead ECG.
• Utilized ⁸²Rb PET-myocardial cardiac stress scintigraphy as the reference standard for reversible ischemia.
• Assessed sensitivity and specificity of both ECG methods against perfusion imaging results.

Main Results:

• Agreement for ST-segment deviations between single- and 12-lead ECG was within acceptable criteria.
• Both single-lead and 12-lead ECG demonstrated high specificity (89.9-91.3%) but poor sensitivity (8.3-12.5%) for detecting reversible anterolateral ischemia.
• The widest limits of agreement were observed in lead V5.

Conclusions:

• While ST-segment deviations show agreement between single- and 12-lead ECG, their clinical utility for detecting reversible ischemia is limited by poor sensitivity.
• Further research is needed to validate these findings and explore the clinical relevance, especially concerning the low sensitivity for anterolateral ischemia detection.