Examining the Specificity of Smartphone ECG Devices in Decision-Making for ST-Elevation Myocardial Infarction and Non-ST-Elevation Myocardial Infarction
Abstract
Background & Objectives: Electrocardiography (ECG) stands as a cornerstone diagnostic tool for assessing cardiac health, particularly in ruling out abnormalities. The integration of smartphone devices presents a promising avenue for expedited detection of cardiac irregularities. This study aims to evaluate the diagnostic efficacy of smartphone ECG devices in subjects admitted to Cardiac Care Units (CCUs) and Cardiac Intensive Care Units (CICUs).
Methods: A retrospective analysis was conducted on a cohort comprising 62 patients presenting with cardiac symptoms. Utilizing smartphone ECG devices as the index, 12-lead ECG tests were administered alongside the Gold Standard ECG machine for comparison among patients in CCUs and CICUs. Diagnostic decisions concerning the presence of ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI) were made by a team of cardiologists following a meticulous review of both sets of ECG reports.
Results: Data analysis was conducted on 56 patients. The smartphone-based ECG device exhibited 100% specificity, 93% sensitivity, 80% Negative Predictive Value, and 100% Positive Predictive Value, yielding an F-score of 0.96 and a Mathew Correlation Coefficient value of 0.86.
Discussions: This study unequivocally underscores the significant potential of the Spandan ECG device in accurately identifying a range of cardiac abnormalities, including critical conditions such as STEMI and ischemia. Despite its portable nature, smartphone ECG technology demonstrates utility within Critical Care Units for timely monitoring and diagnosis.
Downloads
References
Wilson P. W. (1994, July). Established risk factors and coronary artery disease: the Framingham Study. American Journal of Hypertension, 7(7 Pt 2), 7S-12S.
Canto J. G., Kiefe C. I., Rogers W. J., Peterson E. D., Frederick P. D., et al. (2011, November 16). Number of coronary heart disease risk factors and mortality in patients with first myocardial infarction. JAMA, 306(19), 2120-2127.
Hardawar D. (2012). The magic moment: smartphones now half of all U.S. mobiles. VentureBeat. Retrieved from http://venturebeat.com/2012/03/29/the-magic-moment-smartphones-now-half-of-all-u-s-mobiles/.
Steg P. G., James S. K., Atar D., Badano L. P., Blömstrom-Lundqvist C., et al. (2012, October). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 33(20), 2569-2619. doi: 10.1093/eurheartj/ehs215.
Electrocardiogram. NHLBI, NIH. (2016, December 9). Retrieved from https://www.nhlbi.nih.gov.
How Is a Heart Attack Diagnosed? NHLBI, NIH. (2013, December 17). Retrieved from https://www.nhlbi.nih.gov.
Mahajan S., Garg S., Sharma R., Singh Y., Chandola N., Bhatia T., & Bansal B. (2023). Validation of interpretation of ST-elevation myocardial infarction using the smartphone based 12 lead electrocardiograms in comparison to the cardiologist-a cross sectional study, validation study, single-center study. International Journal, 10(2), 1.
Mahajan S., Garg S., Sharma R., Singh Y., Chandola N., Bhatia T., & Bansal B. (2023). Validation of the detection of ischemia using 12 lead smartphone based electrocardiography-a non-randomized, single blinded, cross-sectional, multicenter study. International Journal, 10(2), 1.
Mahajan S., Garg S., Sharma R., Singh Y., Chandola N., Bhatia T., & Bansal B. (2023). Smartphone based 12 lead ECG as decision support in STEMI: a prospective, cross sectional study, non-randomised, single blinded and single-center study. International Journal of Community Medicine and Public Health, 10(4), 1410.
Mahajan S., Garg S., Singh Y., Sharma R., Chandola N., Bhatia T., & Bansal B. (2023). Comparison of ECG Morphological Parameters between a Mobile 12 Lead ECG Compared To the Gold Standard 12 Lead ECG in Cardiology Patients. European Journal of Cardiovascular Medicine, 13(1).
Singh Y., Mahajan S., Garg S., Chandola N., Bhatia T., Sharma R., & Bansal B. A comparative study for evaluating the frequency of false-positive detection in electrocardiogram devices in comparison to cardiologist diagnosis.
Chandola N., Singh Y., Mahajan S., Garg S., & Bansal B. (2022). Validation Study of a Derived 12 Lead Reconstructed ECG Interpretation in a Smartphone-Based ECG Device. In ICT Systems and Sustainability: Proceedings of ICT4SD 2022 (pp. 43-51). Singapore: Springer Nature Singapore.
Muhlestein J. B., Anderson J. L., Bethea C. F., Severance H. W., Mentz R. J., et al. (2019). Feasibility of combining serial smartphone single-Lead electrocardiograms for the diagnosis of ST-elevation myocardial infarction. American Heart Journal. doi:10.1016/j.ahj.2019.12.016.
Müller D., Schnitzer L., Brandt J., Arntz H. R. (2008). The accuracy of an out-of-hospital 12-lead ECG for the detection of ST-elevation myocardial infarction immediately after resuscitation. Annals of Emergency Medicine, 52(6), 658-664. doi: 10.1016/j.annemergmed.2008.06.469.
Towhari J., Masud N., Alanazi H. (2019, June). Evaluation of the diagnostic accuracy of smartphone electrocardiogram recorder compared to standard 12 lead electrocardiography in hospital settings. Saudi Medical Journal, 40(6), 575-581. doi: 10.15537/smj.2019.6.24206.
Ventola C. L. (2014, May). Mobile devices and apps for health care professionals: uses and benefits. P T, 39(5), 356-364. PMID: 24883008.
PDF downloads: 21
Copyright (c) 2025 Indonesian Journal of Cardiology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).