Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy
Wearable wireless electrocardiographic (ECG) monitoring is well-proven for arrythmia detection, but ischemia detection accuracy is not well-described. We aimed to assess the agreement of ST-segment deviation from single- versus 12-lead ECG and their accuracy for the detection of reversible ischemia....
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MDPI AG
2023-03-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/23/6/2962 |
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| author | Luna Fabricius Ekenberg Dan Eik Høfsten Søren M. Rasmussen Jesper Mølgaard Philip Hasbak Helge B. D. Sørensen Christian S. Meyhoff Eske K. Aasvang |
| author_facet | Luna Fabricius Ekenberg Dan Eik Høfsten Søren M. Rasmussen Jesper Mølgaard Philip Hasbak Helge B. D. Sørensen Christian S. Meyhoff Eske K. Aasvang |
| author_sort | Luna Fabricius Ekenberg |
| collection | DOAJ |
| description | Wearable wireless electrocardiographic (ECG) monitoring is well-proven for arrythmia detection, but ischemia detection accuracy is not well-described. We aimed to assess the agreement of ST-segment deviation from single- versus 12-lead ECG and their accuracy for the detection of reversible ischemia. Bias and limits of agreement (LoA) were calculated between maximum deviations in ST segments from single- and 12-lead ECG during <sup>82</sup>Rb PET-myocardial cardiac stress scintigraphy. Sensitivity and specificity for reversible anterior-lateral myocardial ischemia detection were assessed for both ECG methods, using perfusion imaging results as a reference. Out of 110 patients included, 93 were analyzed. The maximum difference between single- and 12-lead ECG was seen in II (−0.019 mV). The widest LoA was seen in V5, with an upper LoA of 0.145 mV (0.118 to 0.172) and a lower LoA of −0.155 mV (−0.182 to −0.128). Ischemia was seen in 24 patients. Single-lead and 12-lead ECG both had poor accuracy for the detection of reversible anterolateral ischemia during the test: single-lead ECG had a sensitivity of 8.3% (1.0–27.0%) and specificity of 89.9% (80.2–95.8%), and 12-lead ECG a sensitivity of 12.5% (3.0–34.4%) and a specificity of 91.3% (82.0–96.7%). In conclusion, agreement was within predefined acceptable criteria for ST deviations, and both methods had high specificity but poor sensitivity for the detection of anterolateral reversible ischemia. Additional studies must confirm these results and their clinical relevance, especially in the light of the poor sensitivity for detecting reversible anterolateral cardiac ischemia. |
| first_indexed | 2024-03-11T05:56:23Z |
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| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-11T05:56:23Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-98149d390b4a4e1ba767efb50252ad0e2023-11-17T13:43:59ZengMDPI AGSensors1424-82202023-03-01236296210.3390/s23062962Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress ScintigraphyLuna Fabricius Ekenberg0Dan Eik Høfsten1Søren M. Rasmussen2Jesper Mølgaard3Philip Hasbak4Helge B. D. Sørensen5Christian S. Meyhoff6Eske K. Aasvang7Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital, 2100 Copenhagen, DenmarkBiomedical Signal Processing & AI Research Group, Digital Health Section, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, DenmarkDepartment of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, DenmarkDepartment of Clinical Physiological and Nuclear Medicine, Center for Diagnostics, Rigshospitalet Copenhagen University Hospital, 2100 Copenhagen, DenmarkBiomedical Signal Processing & AI Research Group, Digital Health Section, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, DenmarkDepartment of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, DenmarkDepartment of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, DenmarkWearable wireless electrocardiographic (ECG) monitoring is well-proven for arrythmia detection, but ischemia detection accuracy is not well-described. We aimed to assess the agreement of ST-segment deviation from single- versus 12-lead ECG and their accuracy for the detection of reversible ischemia. Bias and limits of agreement (LoA) were calculated between maximum deviations in ST segments from single- and 12-lead ECG during <sup>82</sup>Rb PET-myocardial cardiac stress scintigraphy. Sensitivity and specificity for reversible anterior-lateral myocardial ischemia detection were assessed for both ECG methods, using perfusion imaging results as a reference. Out of 110 patients included, 93 were analyzed. The maximum difference between single- and 12-lead ECG was seen in II (−0.019 mV). The widest LoA was seen in V5, with an upper LoA of 0.145 mV (0.118 to 0.172) and a lower LoA of −0.155 mV (−0.182 to −0.128). Ischemia was seen in 24 patients. Single-lead and 12-lead ECG both had poor accuracy for the detection of reversible anterolateral ischemia during the test: single-lead ECG had a sensitivity of 8.3% (1.0–27.0%) and specificity of 89.9% (80.2–95.8%), and 12-lead ECG a sensitivity of 12.5% (3.0–34.4%) and a specificity of 91.3% (82.0–96.7%). In conclusion, agreement was within predefined acceptable criteria for ST deviations, and both methods had high specificity but poor sensitivity for the detection of anterolateral reversible ischemia. Additional studies must confirm these results and their clinical relevance, especially in the light of the poor sensitivity for detecting reversible anterolateral cardiac ischemia.https://www.mdpi.com/1424-8220/23/6/2962single-leadECGwirelessreversible ischemiavalidationST segment |
| spellingShingle | Luna Fabricius Ekenberg Dan Eik Høfsten Søren M. Rasmussen Jesper Mølgaard Philip Hasbak Helge B. D. Sørensen Christian S. Meyhoff Eske K. Aasvang Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy Sensors single-lead ECG wireless reversible ischemia validation ST segment |
| title | Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy |
| title_full | Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy |
| title_fullStr | Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy |
| title_full_unstemmed | Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy |
| title_short | Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy |
| title_sort | wireless single lead versus standard 12 lead ecg for st segment deviation during adenosine cardiac stress scintigraphy |
| topic | single-lead ECG wireless reversible ischemia validation ST segment |
| url | https://www.mdpi.com/1424-8220/23/6/2962 |
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