Session P7C.3

3D Heart Instructional Program Use as a New Tool for the Interpretation and Understanding of 12-Lead ECG Signals

GD Bass*, DG Strauss, D Lange, GS Wagner, CW Olson

Duke University
Durham, NC, USA

The 3D Heart Instructional Program is a personal computer based software that uses three dimensional spatial presentation of ventricular activation to provide a better understanding of the genesis of waveforms in the conventional 12-lead electrocardiographic (ECG) signal. This study tests the hypothesis that use of this software increases accuracy for the identification and localization of myocardial infarction (MI) and bundle branch and fascicular blocks (BB/FB) beyond that attained with traditional didactic methodology for 12-lead ECG interpretation. As a control, the participant’s pre and post training performances regarding abnormalities excluded from the instructional program were compared.
The study subjects (medical students, residents or cardiology fellows) were presented 20 12-lead ECG recordings displayed via PowerPoint software on their personal computer. The abnormalities represented included normal heart, acute MI, and BB/FB. Another category included old MI, hypertrophy syndromes, and Wolff-Parkinson-White Syndrome. Baseline determination of their accuracy for correctly interpreting each 12-lead ECG was measured. Subsequently, each study participant used the 3D Heart Instructional Program to study anterior, inferior and posterior MI, and right and left bundle branch and left anterior and posterior fascicular blocks using the three dimensional computer renderings of both the myocardial activation sequence and vectorcardiographic loops. After the training period, an additional 20 12-lead ECG recordings representing the broad spectrum of abnormalities both included and excluded from the instructional program were presented as previously described. A data sheet provided to each study participant recorded their diagnosis for each of the 20 12-lead ECG recordings both pre and post training with indication of high, medium, or low confidence. Data analysis was performed by an independent evaluator for presentation to the study investigators.
Baseline measures of each study participant’s accuracy from their initial 12-lead ECG interpretation data were compared against post-3D Heart Instructional Program training 12-lead ECG interpretation data for both the abnormalities included and excluded from the instructional program. .
This study is currently in the data collecting phase through May, and data analysis will be performed in June. Results will be available by August for preparation for submission to the Computers in Cardiology meeting at the time designated.

(Abstract Control Number: 81)