Mobile Single-Lead Electrocardiogram Technology for Atrial Fibrillation Detection in Acute Ischemic Stroke Patients

Abstract

(1) Background: AliveCor KardiaMobile (KM) is a portable electrocardiography recorder for detection of atrial fibrillation (AF). The aim of the study was to define the group of acute ischemic stroke (AIS) patients who can use the KM device and assess the diagnostic test accuracy. (2) Methods: the AIS patients were recruited to the study. Thirty-second single-lead electrocardiogram (ECG) usages were recorded on demand for three days using KM portable device. Each KM ECG record was verified by a cardiologist. The feasibility was evaluated using operationalization criteria. (3) Results: the recruitment rate among AIS patients was 26.3%. The withdrawal rate before the start of the intervention was 26%. The withdrawal rate after the start of the intervention was 6%. KM device detected AF in 2.8% of AIS patients and in 2.2% of ECG records. Cardiologist confirmed the AF in 0.3% AIS patients. Sensitivity and specificity of KM for AF was 100% and 98.3%, respectively. (4) Conclusions: the results of this study suggest that it is feasible to use KM device to detect AF in the selected AIS patients (younger and in better neurological condition). KM detected AF in the selected AIS patients with high specificity and sensitivity.

Accuracy of Artificial Intelligence-Based Technologies for the Diagnosis of Atrial Fibrillation: A Systematic Review and Meta-Analysis

“…Regarding the unclassified/unreadable results, we also identified significant heterogeneity in the single-lead ECG group. The reported unclassified/unreadable results ranged from 0% the minimum [32,41,46,52,57] to 38% the maximum (Table 1) [54]. We did not proceed to a formal subgroup analysis regarding the duration of the index test since most of the studies used it for 30 s (Figure 10).…”

“…Their characteristics are summarized in Table 1. Eleven studies had cohort design [11,32,40,42,45,46,48,50,54,56,57] and the rest had case-control design [10,37,41,43,44,47,49,[51][52][53]55]. The total number of participants was 6597.…”

“…The total number of participants was 6597. The smallest study included 50 patients [57] and the biggest study included 1013 patients [32]. Eleven studies were conducted in inpatient setting [37,41,43,45,46,[50][51][52]54,55,57], 6 studies were conducted in outpatient setting [10,11,32,48,49,56], 2 studies were conducted in both settings [40,44] and in 3 studies the setting was not clear [42,47,53].…”

“…Eleven studies were conducted in inpatient setting [37,41,43,45,46,[50][51][52]54,55,57], 6 studies were conducted in outpatient setting [10,11,32,48,49,56], 2 studies were conducted in both settings [40,44] and in 3 studies the setting was not clear [42,47,53]. Eight studies tested smartwatches [10,40,[42][43][44]47,50,53] and the rest of studies tested other devices [11,32,37,41,45,46,48,49,51,52,[54][55][56][57]. Five studies [10,46,47,51,53] tested more than one device...…”

“…Twelve studies [11,37,40,41,43,45,47,49,52,55] were deemed to be at high risk of bias in the participants' domain, nine studies [11,32,45,49,51,54,57] in the index test domain, four studies [45,53] in the reference standard domain, and two studies [11,45] were deemed to be at high risk of bias in the flow and timing domain (Figure 3). The studies were low in risk regarding their applicability (Figure 6).…”