title: Accuracy of EASI 12-lead ECGs in monitoring ST-segment and J-point by nurses in the Coronary Care Units.
abstract: OBJECTIVE
  To confirm the accuracy of the EASI system compared to the standard 12-lead electrocardiogram, which is the gold standard, in monitoring the two major parameters used in the Coronary Care Units to detect myocardial ischaemia: ST-segment and J-point.
  
  
  BACKGROUND
  Continuous electrocardiograph monitoring is used in the Coronary Care Units to detect cardiac conduction abnormalities and to show the morphology of electrocardiographic waves and tracts. Its accuracy is essential for efficient nursing vigilance, particularly for monitoring the ST segment and the J-point, in which alterations may indicate the onset of myocardial ischaemia.
  
  
  METHODS
  An observational study was conducted.
  
  
  METHODS
  The enrolled patients (n = 253) simultaneously underwent standard electrocardiogram (10 electrodes) and EASI electrocardiogram (five electrodes). Data were collected by the Coronary Care Units nurses. Tests to compare differences in means and medians between the two sets of measurements were performed, and the Bland-Altman plots were used to illustrate their agreement.
  
  
  RESULTS
  All 6·072 electrocardiographic leads (3·036 standard and 3·036 EASI) were recorded and analysed. Between the two measurement methods, very small statistically significant differences were found in some leads which are not clinically relevant for both the ST-segment or the J-point.
  
  
  CONCLUSIONS
  This study confirms that the accuracy of the EASI 12-leadelectrocardiogram, compared to the standard 12-leadelectrocardiogram, which is the gold standard, is acceptable for clinical practice to monitor the two major parameters used in the Coronary Care Units for detecting myocardial ischaemia: ST-segment and J-point.
  
  
  CONCLUSIONS
  The EASI system ensures: (1) ease of use and comfort for patients admitted to Coronary Care Units because it only requires five electrodes; (2) increased efficacy of nursing vigilance in the early detection of changes in ST-segment and J- point measurements.
authors.affiliation: Department of Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Lancia
authors.initials: L
authors.lastname: Loreto
authors.affiliation: Nursing Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Toccaceli
authors.initials: T
authors.lastname: Andrea
authors.affiliation: Nursing Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Dignani
authors.initials: D
authors.lastname: Lucia
authors.affiliation: Nursing Science, University of L'Aquila, L'Aquila, Italy.
authors.forename: Lucertini
authors.initials: L
authors.lastname: Carla
authors.affiliation: Department of Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Petrucci
authors.initials: P
authors.lastname: Cristina
authors.affiliation: Department of Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Romano
authors.initials: R
authors.lastname: Silvio
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000451:nursing; D003325:Coronary Care Units; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000451:nursing; D057184:Practice Patterns, Nurses'; D012680:Sensitivity and Specificity
keywords: Coronary Care Unit; EASI lead system; ECG monitoring; J-point; ST segment; nursing practice; nursing vigilance