title: Wireless Smartphone ECG Enables Large-Scale Screening in Diverse Populations.
abstract: BACKGROUND
  The ubiquitous presence of internet-connected phones and tablets presents a new opportunity for cost-effective and efficient electrocardiogram (ECG) screening and on-demand diagnosis. Wireless, single-lead real-time ECG monitoring supported by iOS and android devices can be obtained quickly and on-demand. ECGs can be immediately downloaded and reviewed using any internet browser.
  
  
  OBJECTIVE
  We compared the standard 12-lead ECG to the smartphone ECG in healthy young adults, elite athletes, and cardiology clinic patients. Accuracy for determining baseline ECG intervals and rate and rhythm was assessed.
  
  
  METHODS
  In 381 participants, 30-second lead I ECG waveforms were obtained using an iPhone case or iPad. Standard 12-lead ECGs were acquired immediately after the smartphone tracing was obtained. De-identified ECGs were interpreted by automated algorithms and adjudicated by two board-certified electrophysiologists.
  
  
  RESULTS
  Both smartphone and standard ECGs detected atrial rate and rhythm, AV block, and QRS delay with equal accuracy. Sensitivities ranged from 72% (QRS delay) to 94% (atrial fibrillation). Specificities were all above 94% for both modalities.
  
  
  CONCLUSIONS
  Smartphone ECG accurately detects baseline intervals, atrial rate, and rhythm and enables screening in diverse populations. Efficient ECG analysis using automated discrimination and an enhanced smartphone application with notification capabilities are features that can be easily incorporated into the acquisition process.
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Zachary C
authors: ZC
authors: Haberman
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Ryan T
authors: RT
authors: Jahn
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Rupan
authors: R
authors: Bose
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Han
authors: H
authors: Tun
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Jerold S
authors: JS
authors: Shinbane
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Rahul N
authors: RN
authors: Doshi
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Philip M
authors: PM
authors: Chang
authors: Keck School of Medicine of USC, Los Angeles, California, USA.
authors: Leslie A
authors: LA
authors: Saxon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology; D054537:Atrioventricular Block / Q000175:diagnosis / Q000503:physiopathology; D001292:Attitude to Computers; D001331:Automation; D016022:Case-Control Studies; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006339:Heart Rate; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D008875:Middle Aged; D063731:Mobile Applications; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted; D000068997:Smartphone; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000295:instrumentation*; D013686:Telemetry / Q000295:instrumentation*; D059015:Wireless Technology / Q000295:instrumentation*; D055815:Young Adult
keywords: AliveCor; atrial fibrillation; electrocardiogram; screening; smartphone; telemetry