Presentation Abstract

Session: SP23. Innovation Poster Session II
Friday, May 11, 2012, 9:00 AM - 5:00 PM
Presentation: IA02-1 - Accuracy and Novelty of an Inexpensive iPhone-based Event Recorder
Location: Exhibit Hall
Presenter: Paul Garabelli, MD, David Albert, MD and Dwight Reynolds, MD. University of Oklahoma Health Sciences Center, Oklahoma City, OK, AliveCor, Oklahoma City, OK
Abstract: Introduction
Smartphones are important tools for physicians and patients. This study is a comparison of accuracy between an ECG lead I from a conventional 12-lead ECG and an iPhone-based device, which is a low cost phone case with 2 metal electrodes (Figure 1A). When the electrodes are held by both hands, a lead I rhythm strip is recorded and uploaded by the integrated software with easy provider access for review. This device has been used to diagnose arrhythmias but the accuracy of its recordings has not been assessed.

Methods
12-lead ECGs (Mac5500, GE Healthcare) with gel-based electrodes and lead I ECGs (AliveCor ECG, AliveCor) were recorded in 67 patients. Lead I recordings were low pass filtered at 40 Hz and compared visually for morphology and statistically analyzed for R-wave amplitude differences using Student’s t-test. Five patients with pacemakers had the iPhone placed directly on the chest as well to record a V3-V4 rhythm strip, and 2 physician reviewers cross-validated these strips for pacing spikes.

Results/Applications
In 62 patients, 2 physicians found the QRS morphology to be the same between device recordings, though the iPhone-based ECG had more baseline noise than the standard ECG (Figure 1B). The mean/SD of the R-wave amplitudes for the standard and iPhone recordings respectively were 0.77/0.24 (mV) and 0.78/0.24 (mV), P<0.0001. In the 5 patients with pacemakers, pacing spike artifacts were clearly identified in all 5 enabling verification of pacing capture (Figure 1C).

Next Steps
The iPhone-based event recorder is an accurate clinical tool for ECG assessment and could prove to be a new tool for allowing immediate recording and analysis of an ECG rhythm.

Disclosures:  P. Garabelli: None. D. Albert: C - Equity Interests/Stock Options; 5; AliveCor. G - Officer, Director, or In Any Other Fiduciary Role; 5; AliveCor. K - Salary; 5; AliveCor. D. Reynolds: A - Consulting Fees/Honoraria; 2; Medtronic, Inc., Sorin Group, St. Jude Medical. B - Speaker's Bureau; 2; Medtronic, Inc., Sorin Group. I - Research Grants; 2; Biotronik, Medtronic, Inc..



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