Cross-Sectional, Non-Randomized, Single-Blinded, and Single-Center Study for the Accuracy of 12 Lead Smartphone ECG in the Detection of Ventricular Arrhythmias

Abstract

Since ventricular arrhythmias are frequently transitory, diagnosing them can be difficult. It has been investigated in the past to diagnose atrial fibrillation (AF) using a smartphone-based ECG. Data on the diagnostic efficacy of smartphone-based ECGs for ventricular arrhythmias, however, is insufficient. Objective: Objectives of this study were a) to evaluate the accuracy of the spandan 12 lead ECG device in detection of the ventricular arrhythmias in comparison to the cardiologist, b) to evaluate the arrhythmia detection accuracy of the conventional ECG machine and spandan smartphone ECG machine to cardiologist diagnosis, and c) to detect spontaneous ventricular arrhythmias (VAs), namely ventricular tachycardia (VT) and supraventricular ectopic (SVE), ventricular ectopics (VE), ventricular premature complexes (VPCs), AV-block and ventricular ectopics (VE) can be fatal. Patients who are susceptible to VT/SVTs always have a risk of sudden cardiac death. Methods: This cross-sectional study, single blinded and single-centric study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun from 02-Aug-2022 to 29-Dec-2022. Patients with (n=1137) chest pain, syncope, palpitation, shortness of breath were enrolled from ECG department. A final total of 84 participants considered for the accuracy of interpretation of ventricular arrhythmia detected by the gold standard 12 lead ECG and smartphone-based ECG device along with the cardiologist’s diagnosis. Results: Mean age (SD) was 54.42±14.58 years. The male gender (65.89%) shows the maximum frequency than female gender. Confusion matrix was referred to derive true positive cases for 12 lead standard ECG and smartphone ECG along with the cardiologist’s diagnosis was 46 as compared to 30 from 12 lead gold standard. Sensitivity of smartphone spandan ECG (35.38%) was better than gold standard 12 lead ECG (15.625%), and, PPV and NPV of smartphone spandan ECG was recorded to be better than gold standard 12 lead ECG. Ventricular arrhythmia was detected correctly in 46 (54.7%) cases and 30 (36.58%) cases by smartphone ECG and 12 lead gold standard, respectively. Conclusion: Mobile ECG based devices can be used for detecting the arrhythmias as its overall accuracy of smartphone ECG in detecting the arrhythmias increase by 66.8%, i.e. the significance rise in accuracy of computer interpretation when compared to the cardiologist’s diagnosis.