Comparison of AliveCor KardiaMobile Six-Lead ECG with Standard ECG in Pediatric Patients

Abstract

Background: The AliveCor KardiaMobile (ACKM) is a remote electrocardiogram (ECG) monitoring device.Little research has been conducted on its accuracy with pediatric patients. This prospective study aims to compare the ACKM six-lead device with a standard fteen-lead ECG in measuring the QTc, QRS, and axis in pediatric patients.Methods: Pediatric patients ages 5 to 21 years were enrolled prospectively to have their ECG recorded using an ACKM six-lead device following a recording with the standard fteen-lead ECG. A pediatric electrophysiologist measured the QTc, QRS interval, and QRS axis for both ECGs. Bland-Altman analysis was performed to assess agreement among measurements.Results: The study included 141 patients. The mean age was 12.3 ± 4.4 years. Average heart rate was 79 ± 16 bpm. The mean difference in the QTc measurements for a paired standard ECG and ACKM was -0.6 ms [95% con dence interval -48 to 47 ms]. Of the ACKM QTc measurements, 117 (83%) were within 30 ms of the standard ECG. The mean difference in paired QRS measurements was -1.3 ms [95% con dence interval -23 to 21 ms]. Of the ACKM QRS measurements, 134 (95%) were within 20 ms of the standard ECG. The measured axis was the same for 84% of ACKM and standard ECGs.Conclusions: Over 80% of the ACKM six-lead ECGs produced QTc, QRS, and axis deviation measurements within a clinically useful range of the standard ECG. However, it is not accurate enough to be used consistently in place of a standard ECG for QTc and QRS measurement for pediatric patients.

Utility and acceptability of remote 6-lead electrocardiographic monitoring in children with inherited cardiac conditions

“…Using a binary outcome of normal or abnormal QTc based on prespecified values, with the 12-lead ECG as reference gold standard, the sensitivity (76%) of the KM6LECG for detecting a prolonged QTc was higher than the 54% reported in a previous work using the KM6LECG in children, with similar specificity. 23 From the sensitivity analysis, the overall reliability of the unsupervised KM6LECG was improved by removing potentially overestimated measures.…”