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Borde DP, Khade S, Joshi P, Bhosale R, Shinde P, Takalkar U, Takalkar M, Wavhal D, George A, Borgaonkar D. Diagnostic Accuracy of a Novel Wireless, Bluetooth-Enabled Simultaneous 12-Lead Portable ECG Device Compared with Standard ECG in Preoperative Patient Population. Ann Card Anaesth 2024; 27:309-315. [PMID: 39365128 DOI: 10.4103/aca.aca_79_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/30/2024] [Indexed: 10/05/2024] Open
Affiliation(s)
| | | | - Pooja Joshi
- Ozone Anesthesia group, Aurangabad, Maharashtra, India
| | | | | | - Unmesh Takalkar
- Department of Surgery, Care CIIGMA Hospital, Aurangabad, Maharashtra, India
| | - Manisha Takalkar
- Department of Anesthesia, Care CIIGMA Hospital, Aurangabad, Maharashtra, India
| | - Diksha Wavhal
- Department of Surgery, Care CIIGMA Hospital, Aurangabad, Maharashtra, India
| | - Antony George
- Department of Cardiac Anesthesia, Lissie Hospital, Kochi, Kerala, India
| | - Devendra Borgaonkar
- Department of Cardiology, Seth Nandlal Dhoot Hospital, Aurangabad, Maharashtra, India
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Lawley CM, Luczak-Wozniak K, Chung SC, Field E, Barnes A, Starling L, Cervi E, Kaski JP. Utility and acceptability of remote 6-lead electrocardiographic monitoring in children with inherited cardiac conditions. Arch Dis Child 2024; 109:742-747. [PMID: 38849195 PMCID: PMC11347208 DOI: 10.1136/archdischild-2023-326756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/26/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE This pilot study sought to investigate the utility and acceptability of the KardiaMobile 6-lead ECG (KM6LECG) as a tool for remote monitoring in children with inherited cardiac conditions. DESIGN A single-centre prospective cohort study. Children underwent standard clinical evaluation including a 12-lead ECG and a KM6LECG in the clinic. Participants recorded KM6LECGs monthly at home for 3 months. Families completed a questionnaire on their experience. SETTING Great Ormond Street Hospital Centre for Inherited Cardiovascular Diseases. PARTICIPANTS 64 children: 22 with hypertrophic cardiomyopathy (HCM); 22 with long QT syndrome and 20 unaffected siblings (controls). MAIN OUTCOME MEASURES Comparison of data extracted from the clinic 12-lead ECG and supervised KM6LECG, and the supervised and unsupervised KM6LECG recording. RESULTS Of 64 children (35% female, mean age 12 years), 58 had a baseline 12-lead ECG and appropriate baseline KM6LECG. In children with HCM, abnormalities in ventricular depolarisation/repolarisation in the limb leads of the 12-lead ECG were reliably reproduced. From the whole cohort, there was a strong positive correlation between the corrected QT interval from the 12-lead ECG and baseline KM6LECG (intraclass correlation coefficient=0.839) and baseline KM6LECG with an unsupervised KM6LECG (intraclass correlation coefficient=0.736). Suspected 'lead' misplacement impacted 18% of unsupervised recordings. Overall, the acceptability of the KM6LECG to families was good. CONCLUSIONS The KM6LECG provides an accurate tool for assessing some ECG abnormalities associated with paediatric inherited cardiovascular disease and may provide a useful at-home adjunct to face-to-face clinical care of children requiring ECG assessment.
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Affiliation(s)
- Claire Margaret Lawley
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- The University of Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
| | - Katarzyna Luczak-Wozniak
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warszawa, Poland
| | - Sheng-Chia Chung
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
- Health Data Research UK, Institute of Health Informatics, University College London, London, UK
| | - Ella Field
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
| | - Annabelle Barnes
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
| | - Luke Starling
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
| | - Elena Cervi
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
| | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London, London, UK
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Ghazzal BZ, Refaat MM. The efficiency of using KardiaMobile 6L in the cardiac electrophysiology clinic. J Cardiovasc Electrophysiol 2024; 35:1694-1695. [PMID: 38965807 DOI: 10.1111/jce.16358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 07/06/2024]
Affiliation(s)
- Bahjat Z Ghazzal
- Department of Internal Medicine, Division of Cardiology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Marwan M Refaat
- Department of Internal Medicine, Division of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
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Bergeman AT, Nourdine S, Piubello A, Salim Z, Braet SM, Baco A, Grillone SH, Snijders R, Hoof C, Tsoumanis A, van Loen H, Assoumani Y, Mzembaba A, Ortuño‐Gutiérrez N, Hasker E, van der Werf C, de Jong BC. Feasibility and accuracy of mobile QT interval monitoring strategies in bedaquiline-enhanced prophylactic leprosy treatment. Clin Transl Sci 2024; 17:e13861. [PMID: 39075882 PMCID: PMC11286973 DOI: 10.1111/cts.13861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/30/2024] [Accepted: 06/02/2024] [Indexed: 07/31/2024] Open
Abstract
Some anti-mycobacterial drugs are known to cause QT interval prolongation, potentially leading to life-threatening ventricular arrhythmia. However, the highest leprosy and tuberculosis burden occurs in settings where electrocardiographic monitoring is challenging. The feasibility and accuracy of alternative strategies, such as the use of automated measurements or a mobile electrocardiogram (mECG) device, have not been evaluated in this context. As part of the phase II randomized controlled BE-PEOPLE trial evaluating the safety of bedaquiline-enhanced post-exposure prophylaxis (bedaquiline and rifampicin, BE-PEP, versus rifampicin, SDR-PEP) for leprosy, all participants had corrected QT intervals (QTc) measured at baseline and on the day after receiving post-exposure prophylaxis. The accuracy of mECG measurements as well as automated 12L-ECG measurements was evaluated. In total, 635 mECGs from 323 participants were recorded, of which 616 (97%) were of sufficient quality for QTc measurement. Mean manually read QTc on 12L-ECG and mECG were 394 ± 19 and 385 ± 18 ms, respectively (p < 0.001), with a strong correlation (r = 0.793). The mean absolute QTc difference between both modalities was 11 ± 10 ms. Mean manual and automated 12L-ECG QTc were 394 ± 19 and 409 ± 19 ms, respectively (n = 636; p < 0.001), corresponding to moderate agreement (r = 0.655). The use of a mECG device for QT interval monitoring was feasible and yielded a median absolute QTc error of 8 ms. Automated QTc measurements were less accurate, yielding longer QTc intervals.
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Affiliation(s)
- Auke T. Bergeman
- Department of Cardiology, Heart Centre, Amsterdam UMC location AMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Said Nourdine
- National Tuberculosis and Leprosy Control ProgramMoroniComoros
| | | | - Zahara Salim
- National Tuberculosis and Leprosy Control ProgramMoroniComoros
| | | | - Abdallah Baco
- National Tuberculosis and Leprosy Control ProgramMoroniComoros
| | | | | | | | | | | | | | | | | | - Epco Hasker
- Institute of Tropical MedicineAntwerpBelgium
| | - Christian van der Werf
- Department of Cardiology, Heart Centre, Amsterdam UMC location AMCUniversity of AmsterdamAmsterdamThe Netherlands
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Gaddam M, Liu A, Lohrmann G, Breed A, Passman R. KardiaMobile 6L versus 12-lead ECG: Effects on clinic utilization time. J Cardiovasc Electrophysiol 2024; 35:1691-1693. [PMID: 38894503 DOI: 10.1111/jce.16342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION We aimed to study whether KardiaMobile 6L 30-second capture technology could shorten ECG collection time compared to standard 12L ECG without compromising data usability. METHODS A single-center, non-randomized trial was performed on patients presenting for follow-up visits to the electrophysiology (EP) clinic. Providers in the KardiaMobile 6L group were allowed to request a standard 12L if the 6L was deemed insufficient for clinical care. Room utilization times, defined as the time from medical assistant room entry to exit, were compared for each group. RESULTS There were 100 patients in the study, with 50 in each arm. Average room utilization time for the 12L group and 6L groups were 10.33 ± 2.2 and 7.27 ± 1.93 min, respectively (p < .001). In 8 (16%) visits for the 6L group, an additional 12L was requested. CONCLUSION For EP follow-up visits, clinic utilization time was significantly reduced with the KardiaMobile 6L compared to the 12L ECG with infrequent need for an additional 12L.
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Affiliation(s)
- Meghna Gaddam
- Division of Cardiology, Northwestern Medicine, Chicago, Illinois, USA
| | - Albert Liu
- Division of Cardiology, University of California San Francisco, San Francisco, California, USA
| | - Graham Lohrmann
- Division of Cardiology, Northwestern Medicine, Chicago, Illinois, USA
| | - Alexis Breed
- Division of Cardiology, Northwestern Medicine, Chicago, Illinois, USA
| | - Rod Passman
- Division of Cardiology, Northwestern Medicine, Chicago, Illinois, USA
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6
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Metcalfe JZ, Economou T, Naufal F, Kucukosmanoglu M, Kleiman R, Phillips PPJ, Conradie F. Validation of a Handheld 6-Lead Device for QT Interval Monitoring in Resource-Limited Settings. JAMA Netw Open 2024; 7:e2415576. [PMID: 38848063 PMCID: PMC11161846 DOI: 10.1001/jamanetworkopen.2024.15576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/08/2024] [Indexed: 06/10/2024] Open
Abstract
Importance Rifampin-resistant tuberculosis treatment regimens require electrocardiographic (ECG) monitoring due to the use of multiple QTc-prolonging agents. Formal 12-lead ECG devices represent a significant burden in resource-constrained clinics worldwide and a potential barrier to treatment scale-up in some settings. Objective To evaluate the diagnostic accuracy of a handheld 6-lead ECG device within resource-constrained clinics. Design, Setting, and Participants This diagnostic study was performed within a multicenter, pragmatic (broad eligibility criteria with no exclusions for randomized participants), phase 3 rifampin-resistant tuberculosis treatment trial (BEAT Tuberculosis [Building Evidence for Advancing New Treatment for Tuberculosis]) in South Africa. A total of 192 consecutive trial participants were assessed, and 191 were recruited for this substudy between January 21, 2021, and March 27, 2023. A low proportion (3 of 432 [0.7%]) of all screened trial participants were excluded due to a QTc interval greater than 450 milliseconds. Triplicate reference standard 12-lead ECG results were human calibrated with readers blinded to 6-lead ECG results. Main Outcomes and Measures Diagnostic accuracy, repeatability, and feasibility of a 6-lead ECG device. Results A total of 191 participants (median age, 36 years [IQR, 28-45 years]; 81 female participants [42.4%]; 91 participants [47.6%] living with HIV) with a median of 4 clinic visits (IQR, 3-4 visits) contributed 2070 and 2015 12-lead and 6-lead ECG assessments, respectively. Across 170 participants attending 489 total clinic visits where valid triplicate QTc measurements were available for both devices, the mean 12-lead QTc measurement was 418 milliseconds (range, 321-519 milliseconds), and the mean 6-lead QTc measurement was 422 milliseconds (range, 288-574 milliseconds; proportion of variation explained, R2 = 0.4; P < .001). At a QTc interval threshold of 500 milliseconds, the 6-lead ECG device had a negative predictive value of 99.8% (95% CI, 98.8%-99.9%) and a positive predictive value of 16.7% (95% CI, 0.4%-64.1%). The normal expected range of within-individual variability of the 6-lead ECG device was high (±50.2 milliseconds [coefficient of variation, 6.0%]) relative to the 12-lead ECG device (±22.0 milliseconds [coefficient of variation, 2.7%]). The mean (SD) increase in the 12-lead QTc measurement during treatment was 10.1 (25.8) milliseconds, with 0.8% of clinic visits (4 of 489) having a QTc interval of 500 milliseconds or more. Conclusions and Relevance This study suggests that simplified, handheld 6-lead ECG devices are effective triage tests that could reduce the need to perform 12-lead ECG monitoring in resource-constrained settings.
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Affiliation(s)
- John Z. Metcalfe
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | - Tamsin Economou
- Department of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Fahd Naufal
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | | | | | - Patrick P. J. Phillips
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | - Francesca Conradie
- Department of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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7
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Miller N, Catherall D, Pompa AG, Roelle L, Conner T, Orr WB, Avari Silva JN. Use of digital health technologies in periprocedural pediatric cardiac ablation. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2024; 5:173-177. [PMID: 38989043 PMCID: PMC11232418 DOI: 10.1016/j.cvdhj.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Affiliation(s)
- Nathan Miller
- Electrophysiology Laboratory, St. Louis Children's Hospital, St. Louis, Missouri
| | - David Catherall
- Washington University School of Medicine, St. Louis, Missouri
| | - Anthony G Pompa
- Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, Missouri
| | - Lisa Roelle
- Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, Missouri
| | - Tracy Conner
- Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, Missouri
| | - William B Orr
- Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, Missouri
| | - Jennifer N Avari Silva
- Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, Missouri
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri
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Westwood M, Armstrong N, Posadzki P, Noake C. KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review. Health Technol Assess 2024; 28:1-94. [PMID: 38551306 PMCID: PMC11017144 DOI: 10.3310/tfhu0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Background The indication for this assessment is the use of the KardiaMobile six-lead electrocardiogram device for the assessment of QT interval-based cardiac risk in service users prior to the initiation of, or for the monitoring of, antipsychotic medications, which are associated with an established risk of QT interval prolongation. Objectives To provide an early value assessment of whether KardiaMobile six-lead has the potential to provide an effective and safe alternative to 12-lead electrocardiogram for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications. Review methods Twenty-seven databases were searched to April/May 2022. Review methods followed published guidelines. Where appropriate, study quality was assessed using appropriate risk of bias tools. Results were summarised by research question; accuracy/technical performance; clinical effects (on cardiac and psychiatric outcomes); service user acceptability/satisfaction; costs of KardiaMobile six-lead. Results We did not identify any studies which provided information about the diagnostic accuracy of KardiaMobile six-lead, for the detection of corrected QT-interval prolongation, in any population. All studies which reported information about agreement between QT interval measurements (corrected and/or uncorrected) with KardiaMobile six-lead versus 12-lead electrocardiogram were conducted in non-psychiatric populations, used cardiologists and/or multiple readers to interpret electrocardiograms. Where reported or calculable, the mean difference in corrected QT interval between devices (12-lead electrocardiogram vs. KardiaMobile six-lead) was generally small (≤ 10 ms) and corrected QT interval measured using KardiaMobile six-lead was consistently lower than that measured using 12-lead electrocardiogram. All information about the use of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication, was taken from retrospective surveys of staff and service users who had chosen to use KardiaMobile six-lead during pilots, described in two unpublished project reports. It is important to note that both these project reports relate to pilot studies which were not intended to be used in wider evaluations of KardiaMobile six-lead for use in the NHS. Both reports included survey results which indicated that the use of KardiaMobile six-lead may be associated with reductions in the time taken to complete an electrocardiogram and costs, relative to 12-lead electrocardiogram, and that KardiaMobile six-lead was preferred over 12-lead electrocardiogram by almost all responding staff and service users. Limitations There was a lack of published evidence about the efficacy of KardiaMobile six-lead for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications. Conclusions There is insufficient evidence to support a full diagnostic assessment evaluating the clinical and cost effectiveness of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication. The evidence to inform the aims of this early value assessment (i.e. to assess whether the device has the potential to be clinically effective and cost-effective) was also limited. This report includes a comprehensive list of research recommendations, both to reduce the uncertainty around this early value assessment and to provide the additional data needed to inform a full diagnostic assessment, including cost-effectiveness modelling. Study registration This study is registered as PROSPERO CRD42022336695. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135520) and is published in full in Health Technology Assessment; Vol. 28, No. 19. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
| | | | | | - Caro Noake
- Kleijnen Systematic Reviews Ltd, York, UK
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Mesitskaya DF, Fashafsha ZZ, Poltavskaya MG, Andreev DA, Levshina AR, Sultygova EA, Gognieva D, Chomakhidze P, Kuznetsova N, Suvorov A, Marina I. S, Poddubskaya E, Novikova A, Bykova A, Kopylov P. A single-lead ECG based cardiotoxicity detection in patients on polychemotherapy. IJC HEART & VASCULATURE 2024; 50:101336. [PMID: 38304727 PMCID: PMC10831811 DOI: 10.1016/j.ijcha.2024.101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/04/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024]
Abstract
Background Anti-cancer treatment can be fraught with cardiovascular complications, which is the most common cause of death among oncological survivors. Without appropriate cardiomonitoring during anti-cancer treatment, it becomes challenging to detect early signs of cardiovascular complications. In order to achieve higher survival rates, it is necessary to monitor oncological patients outpatiently after anti-cancer treatment administration. In this regard, we aim to evaluate the efficacy of single-lead ECG remote monitoring to detect cardiotoxicity in cancer patients with minimal cardiovascular diseases after the first cycle of polychemotherapy. Materials and methods The study included patients 162 patients over 18 years old with first diagnosed different types of solid tumors, planed for adjuvant (within 8 weeks after surgery) or neoadjuvant polychemotherapy. All patients were monitored, outpatiently, during 14-21 days (depending on the regimen of polychemotherapy) after polychemotherapy administration using single-lead ECG. Results QTc > 500 mc prolongation was detected in 8 patients (6.6 %), first-diagnosed arial fibrillation was detected in 11 patients (9 %) in period after chemotherapy administration. Moreover, left ventricular diastolic dysfunction using single-lead ECG after polychemotherapy was detected in 49 (40.1 %) patients with sensitivity 80 %, specificity 95 %, AUC 0.88 (95 % CI, 0.82-0.93). Conclusions The side effects of cancer treatment may cause life-threatening risks. Early identification of cardiotoxicity plays a vital role in the solution of this problem. Using portable devices to detect early cardiotoxicity is a simple, convenient and affordable screening method, that can be used for promptly observation of patients.
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Affiliation(s)
- Dinara F. Mesitskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zaki Z.A. Fashafsha
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Maria G. Poltavskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Denis A. Andreev
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna R. Levshina
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elizaveta A. Sultygova
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Daria Gognieva
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Petr Chomakhidze
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia Kuznetsova
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexander Suvorov
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sekacheva Marina I.
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Institute for Personalized Oncology, Center "Digital Biodesign and Personalized Healthcare" I.M. Sechenov First Moscow State Medical University Moscow, Russia Moscow, Russia
| | - Elena Poddubskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alena Novikova
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aleksandra Bykova
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Philipp Kopylov
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Bergeman AT, Pultoo SNJ, Winter MM, Somsen GA, Tulevski II, Wilde AAM, Postema PG, van der Werf C. Accuracy of mobile 6-lead electrocardiogram device for assessment of QT interval: a prospective validation study. Neth Heart J 2023; 31:340-347. [PMID: 36063313 PMCID: PMC10444736 DOI: 10.1007/s12471-022-01716-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Ambulatory assessment of the heart rate-corrected QT interval (QTc) can be of diagnostic value, for example in patients on QTc-prolonging medication. Repeating sequential 12-lead electrocardiograms (ECGs) to monitor the QTc is cumbersome, but mobile ECG (mECG) devices can potentially solve this problem. As the accuracy of single-lead mECG devices is reportedly variable, a multilead mECG device may be more accurate. METHODS This prospective dual-centre study included outpatients visiting our cardiology clinics for any indication. Participants underwent an mECG recording using a smartphone-enabled 6‑lead mECG device immediately before or immediately after a conventional 12-lead ECG recording. Multiple QTc values in both recordings were manually measured in leads I and II using the tangent method and subsequently compared. RESULTS In total, 234 subjects were included (mean ± standard deviation (SD) age: 57 ± 17 years; 58% males), of whom 133 (57%) had cardiac disease. QTc measurement in any lead was impossible due to artefacts in 16 mECGs (7%) and no 12-lead ECGs. Mean (± SD) QTc in lead II on the mECG and 12-lead ECG was 401 ± 30 and 406 ± 31 ms, respectively. Mean (± SD) absolute difference in QTc values between both modalities was 12 ± 9 ms (r = 0.856; p < 0.001). In 55% of the subjects, the absolute difference between QTc values was < 10 ms. CONCLUSION A 6-lead mECG allows for QTc assessment with good accuracy and can be used safely in ambulatory QTc monitoring. This may improve patient satisfaction and reduce healthcare costs.
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Affiliation(s)
- A T Bergeman
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Cardiology Centres of the Netherlands, Amsterdam, The Netherlands
| | - S N J Pultoo
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M M Winter
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Cardiology Centres of the Netherlands, Amsterdam, The Netherlands
| | - G A Somsen
- Cardiology Centres of the Netherlands, Amsterdam, The Netherlands
| | - I I Tulevski
- Cardiology Centres of the Netherlands, Amsterdam, The Netherlands
| | - A A M Wilde
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - P G Postema
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - C van der Werf
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- Cardiology Centres of the Netherlands, Amsterdam, The Netherlands.
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Golbus JR. Mobile Health Technology: (Smart)Watch and Wait. JACC Case Rep 2023; 17:101898. [PMID: 37496725 PMCID: PMC10366495 DOI: 10.1016/j.jaccas.2023.101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Affiliation(s)
- Jessica R. Golbus
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Iconaru EI, Ciucurel C. The Relationship between Body Composition and ECG Ventricular Activity in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11105. [PMID: 36078821 PMCID: PMC9518147 DOI: 10.3390/ijerph191711105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/23/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to determine the correlation between body composition (measured as weight, body mass index, and body fat percentage (BFP)) and electrocardiographic ventricular parameters (the QT and TQ intervals and the ratios between the electrical diastole and electrical systole (TQ/QT) and between the cardiac cycle and electrical diastole (RR/TQ), both for uncorrected and corrected intervals) in a sample of 50 healthy subjects (age interval 19-23 years, mean age 21.27 ± 1.41 years, 33 women and 17 men). Subjects' measurements were performed with a bioimpedancemetry body composition analyzer and a portable ECG monitor with six leads. Starting from the correlations obtained between the investigated continuous variables, we performed a standard linear regression analysis between the body composition parameters and the ECG ones. Our results revealed that some of our regression models are statistically significant (p < 0.001). Thus, a specific part of the variability of the dependent variables (ECG ventricular activity parameters for corrected QT intervals) is explained by the independent variable BFP. Therefore, body composition influences ventricular electrical activity in young adults, which implies a differentiated interpretation of the electrocardiogram in these situations.
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Mannhart D, Hennings E, Lischer M, Vernier C, Du Fay de Lavallaz J, Knecht S, Schaer B, Osswald S, Kühne M, Sticherling C, Badertscher P. Clinical Validation of Automated Corrected QT-Interval Measurements From a Single Lead Electrocardiogram Using a Novel Smartwatch. Front Cardiovasc Med 2022; 9:906079. [PMID: 35811720 PMCID: PMC9259864 DOI: 10.3389/fcvm.2022.906079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The Withings Scanwatch (Withings SA, Issy les Moulineaux, France) offers automated analysis of the QTc. We aimed to compare automated QTc-measurements using a single lead ECG of a novel smartwatch (Withings Scanwatch, SW-ECG) with manual-measured QTc from a nearly simultaneously recorded 12-lead ECG. Methods We enrolled consecutive patients referred to a tertiary hospital for cardiac workup in a prospective, observational study. The QT-interval of the 12-lead ECG was manually interpreted by two blinded, independent cardiologists through the tangent-method. Bazett's formula was used to calculate QTc. Results were compared using the Bland-Altman method. Results A total of 317 patients (48% female, mean age 63 ± 17 years) were enrolled. HR-, QRS-, and QT-intervals were automatically calculated by the SW in 295 (93%), 249 (79%), and 177 patients (56%), respectively. Diagnostic accuracy of SW-ECG for detection of QTc-intervals ≥ 460 ms (women) and ≥ 440 ms (men) as quantified by the area under the curve was 0.91 and 0.89. The Bland-Altman analysis resulted in a bias of 6.6 ms [95% limit of agreement (LoA) -59 to 72 ms] comparing automated QTc-measurements (SW-ECG) with manual QTc-measurement (12-lead ECG). In 12 patients (6.9%) the difference between the two measurements was greater than the LoA. Conclusion In this clinical validation of a direct-to-consumer smartwatch we found fair to good agreement between automated-SW-ECG QTc-measurements and manual 12-lead-QTc measurements. The SW-ECG was able to automatically calculate QTc-intervals in one half of all assessed patients. Our work shows, that the automated algorithm of the SW-ECG needs improvement to be useful in a clinical setting.
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Affiliation(s)
- Diego Mannhart
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Elisa Hennings
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Mirko Lischer
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Claudius Vernier
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Jeanne Du Fay de Lavallaz
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Sven Knecht
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Beat Schaer
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Stefan Osswald
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Michael Kühne
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Christian Sticherling
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Patrick Badertscher
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
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Jewson JL, Orchard JW, Semsarian C, Fitzpatrick J, La Gerche A, Orchard JJ. Use of a smartphone electrocardiogram to diagnose arrhythmias during exercise in athletes: a case series. Eur Heart J Case Rep 2022; 6:ytac126. [PMID: 35434508 PMCID: PMC9007431 DOI: 10.1093/ehjcr/ytac126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/29/2021] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
Background While athletes are generally very fit, intense exercise can increase the risk of atrial fibrillation. Moreover, other arrhythmias such as atrial flutter or supraventricular tachycardia can cause distressing, exercise-related symptoms. Given symptoms are infrequent and may occur during intense exertion, traditional monitoring devices are often impractical to use during exercise. Smartphone electrocardiograms (ECGs) such as the Alivecor Kardia device may be the portable and reliable tool required to help identify arrhythmias in this challenging population. This case series highlights the use of such devices in aiding the diagnosis of arrhythmias in the setting of exercise-related symptoms in athletes. Case summary The six cases in this series included one elite non-endurance athlete, two elite cricketers, one amateur middle-distance runner, and two semi-elite ultra-endurance runners, with an age range of 16-48 years. An accurate diagnosis of an arrhythmia was obtained in five cases (atrial fibrillation/flutter and supraventricular tachycardias) using the smartphone ECG, which helped guide definitive treatment. No arrhythmia was identified in the final case despite using the device during multiple symptomatic events. Discussion The smartphone ECG was able to accurately detect arrhythmias and provide a diagnosis in cases where traditional monitoring had not. The utility of detecting no arrhythmia during symptoms in one case was also highlighted, providing the athlete with the confidence to continue exercising. This reassurance and confidence across all cases is perhaps the most valuable aspect of this device, where clinicians and athletes can be more certain of reaching a diagnosis and undertaking appropriate management.
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Affiliation(s)
- Jacob L Jewson
- Olympic Park Sports Medicine Centre, 60 Olympic Bvd, 3004, Melbourne, VIC, Australia
| | - John W Orchard
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Chris Semsarian
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jane Fitzpatrick
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Jessica J Orchard
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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