Session S33.2

Quality of ECG Recording Using a Novel Miniaturized Prototype ECG Recorder as Compared to Standard Holter ECG in Cardiology Department Patients

ME Lemmert*, A Janata, JK Russell, S Gehman,
K Nammi, APM Gorgels

Academic Hospital Maastricht
Maastricht, Netherlands

The ability of a miniaturized skin-attached 3-channel ECG recorder prototype with a largest dimension of less than 10 cm to detect (life-threatening) ventricular ectopic activity was compared with standard Holter ECG.
Included were 143 patients presenting at different cardiac units of the Academic Hospital Maastricht. During 15 hours, ECG data were recorded concurrently using a prototype device provided by Philips Medical Systems, and a commercially available Holter recorder. To assess optimal recording quality, the prototype device was attached to the chest in one of four locations (L1, below left clavicle; L2, midsternal; L3, right to and below left mammilla; L4, anterior axillary line, 5th intercostal space). Interim analysis showed superior recording quality in L1 and L2, but since clinical circumstances restricted the use of L2, L1 was predominantly applied in 118 patients, L2 in 13, L3 in 10, and L4 in 2 patients. Two physicians (M.L., A.J.), blinded for the recording device, analyzed 1788 7-sec-strips for total number of ventricular ectopic beats and total number of their QRS configurations. Differences between the two physicians were solved by a consensus review with a third physician (A.G), also blinded for the recording device. The concurrent strips from the prototype and Holter data were paired and corrected for observer-dependent and thus inappropriate discrepancy in a second consensus process (M.L., A.J., A.G.). Spearman’s correlation coefficients were calculated.
For the total number of ventricular ectopic beats Spearman’s correlation coefficient was 0.98 (95% CI, 0.97-0.99; p < 0.001). For the total number of QRS configurations Spearman’s correlation coefficient was 0.91 (95% CI, 0.88-0.93; p < 0.001).
The accuracy of the miniaturized prototype ECG recorder for detecting ventricular activity was found to be high, provided that the location dependent recording quality is good.

(Abstract Control Number: 78)