Validation of Decisions for Percutaneous Coronary Intervention Using Smartphone-Based Electrocardiogram Device...

Area of Science:

• Cardiology
• Medical Devices
• Digital Health

Background:

• India faces a high burden of acute coronary syndrome, particularly ST-elevation myocardial infarction (STEMI), often in younger populations.
• Smartphone-based electrocardiogram (ECG) devices like Spandan offer potential for early diagnosis and intervention, especially in resource-limited areas.

Purpose of the Study:

• To evaluate the performance and diagnostic capability of the Spandan smartphone ECG device.
• To assess its utility in guiding percutaneous coronary intervention (PCI) decisions based on ST-segment elevation detection.
• To compare Spandan's ST-elevation detection against a gold standard 12-lead ECG.

Main Methods:

• An observational, cross-sectional study was conducted with 184 participants presenting with chest pain.
• The Spandan device's ST-elevation detection was compared to a standard 12-lead ECG (BPL Cardiart).
• Statistical analyses included correlation coefficients and confusion matrix to evaluate diagnostic agreement.

Main Results:

• The Spandan device demonstrated good agreement with the gold standard 12-lead ECG, especially in leads II, III, and AVF.
• No statistically significant difference was found in ST-elevation measurements between Spandan and the 12-lead ECG.
• Spandan achieved 94% sensitivity and 94% positive predictive value for ST-elevation detection.

Conclusions:

• The Spandan smartphone ECG device shows comparable accuracy to traditional 12-lead ECGs for diagnosing ST elevation.
• It can effectively support clinical decision-making for PCI, particularly in resource-limited healthcare settings.
• This technology holds promise for improving acute coronary syndrome management in underserved populations.