Dataset Information

Feasibility of patch-type wireless 12-lead electrocardiogram in laypersons.

ABSTRACT: Various efforts have been made to diagnose acute cardiovascular diseases (CVDs) early in patients. However, the sole option currently is symptom education. It may be possible for the patient to obtain an early 12-lead electrocardiogram (ECG) before the first medical contact (FMC), which could decrease the physical contact between patients and medical staff. Thus, we aimed to verify whether laypersons can obtain a 12-lead ECG in an off-site setting for clinical treatment and diagnosis using a patch-type wireless 12-lead ECG (PWECG). Participants who were ≥ 19 years old and under outpatient cardiology treatment were enrolled in this simulation-based one-arm interventional study. We confirmed that participants, regardless of age and education level, can use the PWECG on their own. The median age of the participants was 59 years (interquartile range [IQR] = 56-62 years), and the median duration to obtain a 12-lead ECG result was 179 s (IQR = 148-221 s). With appropriate education and guidance, it is possible for a layperson to obtain a 12-lead ECG, minimizing the contact with a healthcare provider. These results can be used subsequently for treatment.

SUBMITTER: Yoon S

PROVIDER: S-EPMC10004446 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Feasibility of patch-type wireless 12-lead electrocardiogram in laypersons.

Yoon Sunyoung S Kim Taerim T Kang Eunjin E Heo Sejin S Chang Hansol H Seo Yeoni Y Cha Won Chul WC

Scientific reports 20230310 1

Various efforts have been made to diagnose acute cardiovascular diseases (CVDs) early in patients. However, the sole option currently is symptom education. It may be possible for the patient to obtain an early 12-lead electrocardiogram (ECG) before the first medical contact (FMC), which could decrease the physical contact between patients and medical staff. Thus, we aimed to verify whether laypersons can obtain a 12-lead ECG in an off-site setting for clinical treatment and diagnosis using a pat ...[more]

PMID: 36899040

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Project description:BackgroundCardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established.ObjectiveThe aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport.MethodsThis was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG.ResultsA total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P<.001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03).ConclusionsPerformance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome.Trial registrationClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760.

Project description:OBJECTIVE:This study aims to validate the 12-lead electrocardiogram (ECG) as a biometric modality based on two straightforward binary QRS template matching characteristics. Different perspectives of the human verification problem are considered, regarding the optimal lead selection and stability over sample size, gender, age, heart rate (HR). METHODS:A clinical 12-lead resting ECG database, including a population of 460 subjects with two-session recordings (>1 year apart) is used. Cost-effective strategies for extraction of personalized QRS patterns (100ms) and binary template matching estimate similarity in the time scale (matching time) and dissimilarity in the amplitude scale (mismatch area). The two-class person verification task, taking the decision to validate or to reject the subject identity is managed by linear discriminant analysis (LDA). Non-redundant LDA models for different lead configurations (I,II,III,aVF,aVL,aVF,V1-V6) are trained on the first half of 230 subjects by stepwise feature selection until maximization of the area under the receiver operating characteristic curve (ROC AUC). The operating point on the training ROC at equal error rate (EER) is tested on the independent dataset (second half of 230 subjects) to report unbiased validation of test-ROC AUC and true verification rate (TVR = 100-EER). The test results are further evaluated in groups by sample size, gender, age, HR. RESULTS AND DISCUSSION:The optimal QRS pattern projection for single-lead ECG biometric modality is found in the frontal plane sector (60°-0°) with best (Test-AUC/TVR) for lead II (0.941/86.8%) and slight accuracy drop for -aVR (-0.017/-1.4%), I (-0.01/-1.5%). Chest ECG leads have degrading accuracy from V1 (0.885/80.6%) to V6 (0.799/71.8%). The multi-lead ECG improves verification: 6-chest (0.97/90.9%), 6-limb (0.986/94.3%), 12-leads (0.995/97.5%). The QRS pattern matching model shows stable performance for verification of 10 to 230 individuals; insignificant degradation of TVR in women by (1.2-3.6%), adults ≥70 years (3.7%), younger <40 years (1.9%), HR<60bpm (1.2%), HR>90bpm (3.9%), no degradation for HR change (0 to >20bpm).

Dataset Information

Feasibility of patch-type wireless 12-lead electrocardiogram in laypersons.

Publications

Feasibility of patch-type wireless 12-lead electrocardiogram in laypersons.

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