title: Derived 12-lead electrocardiogram in the assessment of ST-segment deviation and cardiac rhythm.
abstract: BACKGROUND
  There are little data on the validation of 12-lead electrocardiogram (ECG) derived by the EASI lead system used for continuous monitoring in critical care settings.
  
  
  OBJECTIVE
  The objectives of this study were to determine the accuracy of 12-lead ECG derived by the EASI lead system in the detection of ST-segment deviation and cardiac rhythm compared with the standard 12-lead ECG.
  
  
  METHODS
  All patients admitted to the coronary care unit were studied. Kappa statistics was used to calculate the agreement between both ECG systems in the determination of cardiac rhythm and premature ventricular complex morphology. ST-segment analysis was performed in patients with acute coronary syndromes. Pearson correlation was used to correlate the ST-segment deviation between both techniques. The sensitivity and specificity of the determination of significant ST-segment deviation by the EASI lead system were calculated.
  
  
  RESULTS
  There were a total of 282 patients enrolled in this study. There was a complete agreement in the interpretation of cardiac rhythm between the 2 methods (kappa = 1). Analysis of ST-segment deviation of 12-lead ECG also showed a significant correlation (correlation coefficient varied from 0.62 in lead I to 0.823 in lead aVF with a P value of <.001 in all leads) between the 2 methods with very high sensitivity and specificity in the detection of significant ST-segment elevation and depression.
  
  
  CONCLUSIONS
  The 12-lead ECG derived by the EASI lead system is an accurate and reliable information for the assessment of ST-segment deviation and cardiac rhythm in critically ill patients.
authors.affiliation: Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand.
authors.forename: Darawan
authors.initials: D
authors.lastname: Chantad
authors.forename: Rungroj
authors.initials: R
authors.lastname: Krittayaphong
authors.forename: Chulalak
authors.initials: C
authors.lastname: Komoltri
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D016638:Critical Illness; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014672:Vectorcardiography / Q000295:instrumentation / Q000379:methods*; D018879:Ventricular Premature Complexes / Q000175:diagnosis