Feasibility of CardioSecur®, a Mobile 4-Electrode/22-Lead ECG Device, in the Prehospital Emergency Setting

Sebastian Spaich; Hanna Kern; Thomas A Zelniker; Jan Stiepak; Michael Gabel; Erik Popp; Hugo A Katus; Michael R Preusch

doi:10.3389/fcvm.2020.551796

Feasibility of CardioSecur®, a Mobile 4-Electrode/22-Lead ECG Device, in the Prehospital Emergency Setting

Front Cardiovasc Med. 2020 Oct 9:7:551796. doi: 10.3389/fcvm.2020.551796. eCollection 2020.

Authors

Sebastian Spaich^{1

2}, Hanna Kern^{1

3}, Thomas A Zelniker⁴, Jan Stiepak¹, Michael Gabel⁵, Erik Popp³, Hugo A Katus¹, Michael R Preusch¹

Affiliations

¹ Department of Cardiology, Angiology, and Pneumology, University Hospital Heidelberg, Heidelberg, Germany.
² Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
³ Department of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
⁴ Division of Cardiology, Medical University of Vienna, Vienna, Austria.
⁵ Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.

Abstract

Background: This study explores the application of CardioSecur® (CS-ECG), a hand-held 4-electrode/22-lead ECG-device, in comparison with conventional 12-lead electrocardiogram (c12L-ECG) in patients with acute chest pain in the prehospital emergency setting. Methods: CS-ECG systems were provided for two physician-staffed emergency ambulances and parallel recordings of c12L-ECG and CS-ECG were obtained from all patients with acute chest pain. Treating emergency physicians were asked to evaluate the CS-ECG system with a standardized questionnaire. Following study completion, acquired ECGs were analyzed separately by two independent cardiologists blinded to all other medical records. Results: Over a period of 20 months a total of 203 patients were included in our study. According to a standardized questionnaire, 79% of emergency medical professionals preferred application of CS-ECG, with 87% of teams judging CS-ECG to be beneficial for patients. Morover, 79% of physicians reported a reduction in time to definitive diagnosis with implementation of CS-ECG. The majority of professional users attested user-friendliness and feasibility of CS-ECG in terms of easy general handling (94%), application (93%), and placement of electrodes (98%). During prehospital triage, both c12L-ECG and CS-ECG correctly identified 31 (91%) patients with ST-elevation myocardial infarction (STEMI). Conclusion: In this first pilot study, implementation of the CardioSecur®-ECG system in the prehospital emergency setting demonstrated feasibility and user-friendliness so that emergency teams generally preferred CS-ECG to c12L-ECG. Diagnostic yield of CS-ECG was similar to c12L-ECG recordings.

Keywords: ECG; STEMI; acute coronary syndrome; electrocardiogram; feasibility; myocardial infarction; user-friendliness.