Introduction Handheld ECG monitors are increasingly used by both healthcare workers and patients to diagnose cardiac arrhythmias. There is a lack of studies validating the use of handheld devices against the standard 12 lead ECG. The Kardia 6 L is a novel handheld ECG monitor which can produce a 6 lead ECG. In this study we compare the 6 L ECG against the 12 lead ECG. Methods A prospective study consisting of unselected cardiac inpatients and outpatients at Leeds Teaching Hospital NHS Trust. All participants had a 12 and 6 Lead ECGs. All ECG parameters were analysed by using a standard method template for consistency between independent observers. ECGs from the recorders were compared by the following statistical methods: linear regression, Bland Altman, receiver operator curve and kappa analysis. Results There were 1015 patients recruited. The mean differences between recorders were small for PR, QRS, cardiac axis, with receiver operator analysis area under the curve of > 80%. Mean differences for QT and QTc (between recorders) were also small, with AUCs for QT leads of > 75% and AUCs for QTc leads of > 60%. Key findings from Bland-Altman analysis demonstrate overall an acceptable agreement with few outliers instances (<6%, Bland Altman analysis). Conclusion Several parameters recorded by the Kardia 6 L (QT Interval in all six leads, rhythm detection, PR Interval, QRS duration, cardiac axis) perform closely to the gold standard 12 lead ECG. However, that consistency weakens for left ventricular hypertrophy, QRS amplitudes (Lead I & AVL) and ischaemic changes.

Hand held ECG recorders are transforming the way we detect and diagnose heart rhythm disorders. The Kardia 6 L was launched in 2019 to detect and diagnose heart rhythm disorders recording a six lead (limb lead) ECG. Recording and analysis of precordial leads are currently not supported by the Kardia 6 L. In this study we aim to assess if reliable chest lead data can be obtained using a simple modification to the recording system.

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