Diagnostic accuracy of multi-lead ECGs obtained using a pocket-sized bipolar handheld event recorder

Abstract

Background: Handheld ECG event recorders are useful for rhythm monitoring but only record a single lead, which may limit interpretation. We sought to investigate if a multi-lead ECG may be reconstituted using this device, and aimed to evaluate diagnostic accuracy.

Methods: A commercially-available handheld bipolar ECG event recorder was used to reconstruct a 9-lead ECG (leads I, II and III, V1-6). Tracings were analyzed independently by a cardiologist and a fellow.

Results: A total of 52 patients were evaluated. Accuracy was excellent (85-98%) for identifying atrial fibrillation, atrioventricular block, bundle branch block and left ventricular hypertrophy, but lower (77-88%) for ST-segment changes and prolonged QTc.

Conclusions: A 9-lead ECG can be reconstituted using a handheld single-lead ECG event recorder, and provides good diagnostic accuracy for common findings.

Keywords: Accuracy; Diagnosis; Electrocardiogram; Event recorder; Multilead; Single-lead.