Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study

Background: Handheld electrocardiograms (ECGs) can be used easily in remote centers at low cost and are therefore attractive options for rural, low-income settings. A modification to the Kardia 6L ECG has been developed to record chest leads V2 and V4 by placing the device electrodes in standard V2...

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Main Authors: Thomas A. Slater, PhD, Redemptar Kimeu, MD, Mohamed Jeilan, MD, Kamilu M. Karaye, PhD, Reuben K. Mutagaywa, PhD, Isiaka Alfa, BMBCh, Vincent Y. Shidali, MBBS, Emmanuel Gushi, MBBS, Julius C. Mwita, MD, Omphemetse Mocheko, RN, Lamyaa Allam, PhD, Okechukwu S. Ogah, PhD, Bashir G. Ahmad, MBBS, Ashley Chin, MPhil, Razeen Gopal, MD, Philip Durkin, BSc, Robert Bowes, BSc, Lucy Leese, BSc, Marcus Ngantcha, MSc, Berthold Stegemann, PhD, Muzahir H. Tayebjee, MD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Heart Rhythm O2
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666501825000959
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author Thomas A. Slater, PhD
Redemptar Kimeu, MD
Mohamed Jeilan, MD
Kamilu M. Karaye, PhD
Reuben K. Mutagaywa, PhD
Isiaka Alfa, BMBCh
Vincent Y. Shidali, MBBS
Emmanuel Gushi, MBBS
Julius C. Mwita, MD
Omphemetse Mocheko, RN
Lamyaa Allam, PhD
Okechukwu S. Ogah, PhD
Bashir G. Ahmad, MBBS
Ashley Chin, MPhil
Razeen Gopal, MD
Philip Durkin, BSc
Robert Bowes, BSc
Lucy Leese, BSc
Marcus Ngantcha, MSc
Berthold Stegemann, PhD
Muzahir H. Tayebjee, MD
author_facet Thomas A. Slater, PhD
Redemptar Kimeu, MD
Mohamed Jeilan, MD
Kamilu M. Karaye, PhD
Reuben K. Mutagaywa, PhD
Isiaka Alfa, BMBCh
Vincent Y. Shidali, MBBS
Emmanuel Gushi, MBBS
Julius C. Mwita, MD
Omphemetse Mocheko, RN
Lamyaa Allam, PhD
Okechukwu S. Ogah, PhD
Bashir G. Ahmad, MBBS
Ashley Chin, MPhil
Razeen Gopal, MD
Philip Durkin, BSc
Robert Bowes, BSc
Lucy Leese, BSc
Marcus Ngantcha, MSc
Berthold Stegemann, PhD
Muzahir H. Tayebjee, MD
author_sort Thomas A. Slater, PhD
collection DOAJ
description Background: Handheld electrocardiograms (ECGs) can be used easily in remote centers at low cost and are therefore attractive options for rural, low-income settings. A modification to the Kardia 6L ECG has been developed to record chest leads V2 and V4 by placing the device electrodes in standard V2 and V4 position. Objective: The study sought to validate this novel technique against the 12-lead ECG in a multicenter cohort from Africa and the United Kingdom to determine whether recordings are adequate for clinical use. Methods: Adults >18 years of age who required an ECG as part of routine care were invited to participate. A 12-lead ECG was obtained followed by a 6-lead ECG using the Kardia 6L, then V2 and V4 chest lead equivalents were recorded. The primary endpoint was agreement between QT interval measurement in V2 and V4 on 12-lead ECG and Kardia 6L. Secondary endpoints assessed included rate, rhythm, PR interval, QRS duration, QRS amplitude, and ST-segment abnormalities. Results: A total of 1786 recordings were collected from 11 sites. Hypertension was the primary indication for ECG (28%). The coefficient of determination for QT interval in leads V2 and V4 was 0.59 and 0.61, respectively, within the prespecified limit of agreement. The adjusted R2 for multiple ECG parameters was >0.5, indicating satisfactory agreement. Conclusion: Modified chest lead recordings using the Kardia 6L handheld ECG recorder compared well with gold standard 12-lead ECG recordings and provide a basis for future simulated 12-lead ECG recordings using the Kardia 6L. This could improve accessibility of high-quality ECG recording and interpretation in rural, low-income settings.
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spelling doaj-art-fea3cfba5e584cd8a0944e958245c3872025-08-20T01:55:30ZengElsevierHeart Rhythm O22666-50182025-05-016568769510.1016/j.hroo.2025.03.009Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association studyThomas A. Slater, PhD0Redemptar Kimeu, MD1Mohamed Jeilan, MD2Kamilu M. Karaye, PhD3Reuben K. Mutagaywa, PhD4Isiaka Alfa, BMBCh5Vincent Y. Shidali, MBBS6Emmanuel Gushi, MBBS7Julius C. Mwita, MD8Omphemetse Mocheko, RN9Lamyaa Allam, PhD10Okechukwu S. Ogah, PhD11Bashir G. Ahmad, MBBS12Ashley Chin, MPhil13Razeen Gopal, MD14Philip Durkin, BSc15Robert Bowes, BSc16Lucy Leese, BSc17Marcus Ngantcha, MSc18Berthold Stegemann, PhD19Muzahir H. Tayebjee, MD20Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United KingdomDepartment of Cardiology, Aga Khan University Hospital, Nairobi, KenyaDepartment of Cardiology, Aga Khan University Hospital, Nairobi, KenyaDepartment of Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, NigeriaDepartment of Cardiology, Muhimbili University of Health and Allied Science, Dar es Salaam, TanzaniaDepartment of Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, NigeriaCardiology Unit, Department of Internal Medicine, Federal Medical Center, Keffi, NigeriaCardiology Unit, Department of Internal Medicine, Federal Medical Center, Keffi, NigeriaDepartment of Internal Medicine, University of Botswana, Gaborone, Botswana; Department of Internal Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Internal Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, EgyptCardiology Unit, Department of Medicine, University College Hospital Ibadan, University of Ibadan, Ibadan, NigeriaDepartment of Medicine, Muhammad Abdullahi Wase Teaching Hospital, Nassarawa GRA, Kano, NigeriaDivision of Cardiology, Department of Medicine, Groote Schuur Hospital, Cape Town, South AfricaDepartment of Cardiology, Panorama Heart Unit, Cape Town, South AfricaDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United KingdomDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United KingdomDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United KingdomDepartment of Cardiology, Cameroon Cardiovascular Research Network, Douala, CameroonAston Medical Research Institute, Aston University, Birmingham, United KingdomDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; Address reprint requests and correspondence: Dr Muzahir H. Tayebjee, Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, United Kingdom LS1 3EX.Background: Handheld electrocardiograms (ECGs) can be used easily in remote centers at low cost and are therefore attractive options for rural, low-income settings. A modification to the Kardia 6L ECG has been developed to record chest leads V2 and V4 by placing the device electrodes in standard V2 and V4 position. Objective: The study sought to validate this novel technique against the 12-lead ECG in a multicenter cohort from Africa and the United Kingdom to determine whether recordings are adequate for clinical use. Methods: Adults >18 years of age who required an ECG as part of routine care were invited to participate. A 12-lead ECG was obtained followed by a 6-lead ECG using the Kardia 6L, then V2 and V4 chest lead equivalents were recorded. The primary endpoint was agreement between QT interval measurement in V2 and V4 on 12-lead ECG and Kardia 6L. Secondary endpoints assessed included rate, rhythm, PR interval, QRS duration, QRS amplitude, and ST-segment abnormalities. Results: A total of 1786 recordings were collected from 11 sites. Hypertension was the primary indication for ECG (28%). The coefficient of determination for QT interval in leads V2 and V4 was 0.59 and 0.61, respectively, within the prespecified limit of agreement. The adjusted R2 for multiple ECG parameters was >0.5, indicating satisfactory agreement. Conclusion: Modified chest lead recordings using the Kardia 6L handheld ECG recorder compared well with gold standard 12-lead ECG recordings and provide a basis for future simulated 12-lead ECG recordings using the Kardia 6L. This could improve accessibility of high-quality ECG recording and interpretation in rural, low-income settings.http://www.sciencedirect.com/science/article/pii/S2666501825000959ElectrocardiogramECGHandheld ECG6-lead ECGChest leads
spellingShingle Thomas A. Slater, PhD
Redemptar Kimeu, MD
Mohamed Jeilan, MD
Kamilu M. Karaye, PhD
Reuben K. Mutagaywa, PhD
Isiaka Alfa, BMBCh
Vincent Y. Shidali, MBBS
Emmanuel Gushi, MBBS
Julius C. Mwita, MD
Omphemetse Mocheko, RN
Lamyaa Allam, PhD
Okechukwu S. Ogah, PhD
Bashir G. Ahmad, MBBS
Ashley Chin, MPhil
Razeen Gopal, MD
Philip Durkin, BSc
Robert Bowes, BSc
Lucy Leese, BSc
Marcus Ngantcha, MSc
Berthold Stegemann, PhD
Muzahir H. Tayebjee, MD
Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study
Heart Rhythm O2
Electrocardiogram
ECG
Handheld ECG
6-lead ECG
Chest leads
title Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study
title_full Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study
title_fullStr Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study
title_full_unstemmed Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study
title_short Validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents: An Africa Heart Rhythm Association study
title_sort validation of a handheld electrocardiogram 6 lead recorder to obtain chest lead equivalents an africa heart rhythm association study
topic Electrocardiogram
ECG
Handheld ECG
6-lead ECG
Chest leads
url http://www.sciencedirect.com/science/article/pii/S2666501825000959
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