Session S33.6

Quality of ECG Recordings via a Novel Miniaturized Prototype ECG-Recorder as Compared to Standard Holter-ECG in Emergency Ward Patients

A Janata*, ME Lemmert, R Fleischhackl, O Robak, AN Laggner,
JK Russell, E Pernicka, F Sterz, APM Gorgels

Medical University of Vienna
Vienna, Austria

Objectives: Non-invasive long term monitoring of patients at risk of arrhythmias would profit from a miniaturized device. Purpose of this study was to evaluate the quality of ECG signals recorded by a miniaturized 3-channel ECG-recorder.
Methods: Patients at the Department of Emergency Medicine, General Hospital of Vienna, were included. ECG-data were concurrently recorded with a prototype investigational device provided by Philips Medical Systems, and a commercially available Holter recorder (DigiTrak Plus, Philips Medical Systems, Andover, Mass., USA). To find the best recording quality, the device was attached in 4 positions (pos.) (1, below left clavicle; 2, midsternal; 3, right to and below left mammilla; 4, anterior axillar line, 5th intercostal space). 7-sec-strips selected from the continuous recordings were analyzed by 2 physicians with regard to atrial activity, ventricular rhythm and QRS morphology. Differences between the analyses were solved with a third investigator. Finally, the results from the 2 devices were paired and analyzed for correspondence. Any cases of discrepancy were reviewed and corrected for false discrepancy. Data are given as median and the range from the 1st to the 3rd quartile. Group comparison was done with a nonlinear mixed-effects model.
Results and Conclusions: In 90 Patients, 574 pairs of strips were analyzed. In each patient, for each parameter the accordance between the investigational device and the Holter recorder was calculated. The median accordance on P-wave analysis was 100 (33; 100)% [89 (50; 100)% in pos. 1 (n=37), 100 (100; 100)% in pos. 2 (n=28), 75 (17; 95)% in pos. 3 (n=12) and 0 (0; 70)% in pos. 4 (n=13)]. The accordance on rhythm diagnosis was 91 (33; 100)% [84 (33; 100)% in pos. 1, 100 (100; 100)% in pos. 2, 38 (0; 85)% in pos. 3 and 0 (0; 70)% in pos. 4]; and on QRS-width 100 (100; 100)% in all 4 positions. Pos. 2 was significantly better than the other pos. in analysis of p-wave and rhythm (p<0.01). At a midsternal position, a novel miniaturized monitor provided accurate assessment of P and QRS morphologies as well as rhythm diagnosis.

(Abstract Control Number: 198)