PMID- 29736948
OWN - NLM
STAT- MEDLINE
DCOM- 20190906
LR  - 20210109
IS  - 1542-474X (Electronic)
IS  - 1082-720X (Print)
IS  - 1082-720X (Linking)
VI  - 23
IP  - 5
DP  - 2018 Sep
TI  - Chest-lead ST-J amplitudes using arm electrodes as reference instead of the 
      Wilson central terminal in smartphone ECG applications: Influence on ST-elevation 
      myocardial infarction criteria fulfillment.
PG  - e12549
LID - 10.1111/anec.12549 [doi]
LID - e12549
AB  - BACKGROUND: "Smartphone 12-lead ECG" for the assessment of acute myocardial 
      ischemia has recently been introduced. In the smartphone 12-lead ECG either the 
      right or the left arm can be used as reference for the chest electrodes instead 
      of the Wilson central terminal. These leads are labeled "CR leads" or "CL leads." 
      We aimed to compare chest-lead ST-J amplitudes, using either CR or CL leads, to 
      those present in the conventional 12-lead ECG, and to determine sensitivity and 
      specificity for the diagnosis of STEMI for CR and CL leads. METHODS: Five hundred 
      patients (74 patients with ST elevation myocardial infarction (STEMI), 66 
      patients with nonischemic ST deviation and 360 controls) were included. 
      Smartphone 12-lead ECG chest-lead ST-J amplitudes were calculated for both CR and 
      CL leads. RESULTS: ST-J amplitudes were 9.1 +/- 29 muV larger for CR leads and 
      7.7 +/- 42 muV larger for CL leads than for conventional chest leads (V leads). 
      Sensitivity and specificity were 94% and 95% for CR leads and 81% and 97% for CL 
      leads when fulfillment of STEMI criteria in V leads was used as reference. In 
      ischemic patients who met STEMI criteria in V leads, but not in limb leads, STEMI 
      criteria were met with CR or CL leads in 91%. CONCLUSION: By the use of CR or CL 
      leads, smartphone 12-lead ECG results in slightly lower sensitivity in STEMI 
      detection. Therefore, the adjustment of STEMI criteria may be needed before 
      application in clinical practice.
CI  - (c) 2018 The Authors. Annals of Noninvasive Electrocardiology Published by Wiley 
      Periodicals, Inc.
FAU - Lindow, Thomas
AU  - Lindow T
AUID- ORCID: 0000-0002-2943-0034
AD  - Department of Clinical Physiology, Vaxjo Central Hospital, Vaxjo, Sweden.
AD  - Department of Clinical Sciences Lund, Clinical Physiology, Skane University 
      Hospital, Lund University, Lund, Sweden.
FAU - Engblom, Henrik
AU  - Engblom H
AD  - Department of Clinical Sciences Lund, Clinical Physiology, Skane University 
      Hospital, Lund University, Lund, Sweden.
FAU - Khoshnood, Ardavan
AU  - Khoshnood A
AD  - Department of Clinical Sciences Lund, Emergency Medicine, Skane University 
      Hospital, Lund University, Lund, Sweden.
FAU - Ekelund, Ulf
AU  - Ekelund U
AD  - Department of Clinical Sciences Lund, Emergency Medicine, Skane University 
      Hospital, Lund University, Lund, Sweden.
FAU - Carlsson, Marcus
AU  - Carlsson M
AD  - Department of Clinical Sciences Lund, Clinical Physiology, Skane University 
      Hospital, Lund University, Lund, Sweden.
FAU - Pahlm, Olle
AU  - Pahlm O
AD  - Department of Clinical Sciences Lund, Clinical Physiology, Skane University 
      Hospital, Lund University, Lund, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20180507
PL  - United States
TA  - Ann Noninvasive Electrocardiol
JT  - Annals of noninvasive electrocardiology : the official journal of the 
      International Society for Holter and Noninvasive Electrocardiology, Inc
JID - 9607443
SB  - IM
MH  - Arm
MH  - Electrocardiography/*instrumentation/*methods
MH  - Electrodes
MH  - Humans
MH  - Reproducibility of Results
MH  - ST Elevation Myocardial Infarction/*diagnosis
MH  - Sensitivity and Specificity
MH  - *Smartphone
PMC - PMC6931535
OTO - NOTNLM
OT  - CL leads
OT  - CR leads
OT  - ST-elevation myocardial infarction criteria
OT  - Wilson central terminal
OT  - smartphone 12-lead ECG
COIS- None (all authors).
EDAT- 2018/05/08 06:00
MHDA- 2019/09/07 06:00
PMCR- 2018/05/07
CRDT- 2018/05/09 06:00
PHST- 2017/12/22 00:00 [received]
PHST- 2018/02/20 00:00 [accepted]
PHST- 2018/05/08 06:00 [pubmed]
PHST- 2019/09/07 06:00 [medline]
PHST- 2018/05/09 06:00 [entrez]
PHST- 2018/05/07 00:00 [pmc-release]
AID - ANEC12549 [pii]
AID - 10.1111/anec.12549 [doi]
PST - ppublish
SO  - Ann Noninvasive Electrocardiol. 2018 Sep;23(5):e12549. doi: 10.1111/anec.12549. 
      Epub 2018 May 7.