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Ease and accuracy of ECG interpretation using 12-lead ECG versus a combination of 12-lead and vector ECG
Tipparaju Hasitha1, Nikhil Singhania2, Suresh Kumar Sukumaran2
1JIPMER, India.
Background:
The Electrocardiogram (ECG) can be visualised either in a scalar form, as waves in the standard 12‑lead ECG, or vectorially, as vector loops in different planes in the Vectorcardiogram (VCG). An Electro-Vectorcardiogram (ECG-VCG) is a graphic visualization combining scalar and vector ECGs. We aimed to assess if integrating the scalar 12‑lead ECG and vector ECG makes ECG interpretation by medical students more accurate, faster, and easier than using 12‑lead ECG alone.
Methods:
Undergraduate medical students were randomised into ECG group and ECG-VCG group. The students received a web-based tutorial followed by a test. The ECG group were taught with and had to interpret standard 12‑lead ECG images, while the ECG-VCG group were taught and had to interpret ECG-VCG images with two-dimensional VCG panels (frontal and horizontal) of the same diagnosis. On completion, participants reported their ease of interpretation as grades. Test scores, time taken and ease were compared between the groups.
Results:
The study included 296 medical students. The primary outcome, interpretation accuracy (test score out of 10), was significantly greater in the ECG-VCG group (7.34 ± 2.13 vs 6.09 ± 2.34, p < 0.001). The time taken for interpretation was significantly lower and ease of interpretation was significantly greater in the ECG-VCG group.
Conclusion:
The use of ECG-VCG to teach undergraduate medical students can outperform the 12‑lead ECG in terms of accuracy, speed and ease.
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