Czy jest możliwa automatyczna interpretacja EKG za pomocą zdjęcia wykonanego smartfonem?

Abstract

Introduction. Nowadays there are no tools enabling fast digitalization and supporting interpretation of paper ECG recordings. Popularity and availability of devices like smartphone could be used in clinical practice as tools enhancing the interpretation of ECG recordings. The aim of the study is to determine possibilities of using free mobile application and smartphone in assessment of QRS frequency and electrical axis of the heart as a basis for more advanced analysis. Materials and methods. Fifty recordings of 12-lead ECG at 25 mm/s generated by devices of various producers were qualified for the analysis. Each of the recordings was assessed as diagnostic by two cardiologists, who also measured the frequency of QRS complexes, electrical axis of the heart, duration of QT, amplitude and duration of QRS complexes and T waves. Afterwards, automatic interpretation of ECG recordings was performed with educational mobile application eEKG (available for free at AppStore and Google Play) and iPhone 5s. The pictures of ECG waveforms were taken according to instruction of the application. The results of expert assessment and automatic interpretation were compared. The 10% acceptable margin of error was established for assessment of frequency of QRS complexes by the application. Results. Six hundred ECG waveforms (12 leads in every ECG recording) were analysed for frequency of QRS complexes and 50 ECG recordings were analyzed for electrical axis of the heart. The application qualified as diagnostic 573 (95.5%) attempts of QRS frequency assessment and 26 (52%) attempts of electrical axis of the heart assessment. The assessment was accurate in 82% of attempts for QRS complexes frequency assessment and in 96% of attempts for electrical axis of the heart assessment. Significant correlation was proven between QT duration, T wave amplitude, ratio of amplitudes of QRS complexes and T waves and effectiveness of automatic interpretation of ECG waveform. Conclusions. Effective digitalisation and automatic interpretation of ECG recording in assessment of frequency of QRS complexes and electrical axis of the heart is possible with mobile application and smartphone type device.