De la Torre-Paz JE, Mo-Ye G, Elenes-Zazueta N, Lagunas-Uriarte OA, Triano-Doroteo JL, De los Ríos-Ibarra JR, Moya-Sánchez DN

Idioma: Español
Referencias bibliográficas: 25
Paginas: 173-181
Archivo PDF: 442.94 Kb.

RESUMEN

Antecedentes: La clasificación del ritmo cardiaco en urgencias requiere electrocardiografía o monitor, por lo que la tecnología celular podría ser una alternativa más accesible. La pronta clasificación del ritmo en un servicio de urgencias puede salvar vidas.
Objetivo: Evaluar la exactitud de las lecturas electrocardiográficas obtenidas con un electrocardiograma convencional vs celular.
Materiales y Métodos: Estudio de cohortes prospectivo, efectuado en el servicio de Urgencias Médicas del Hospital Civil de Culiacán, México. Se realizaron electrocardiografía de 12 derivaciones y electrocardiografía celular a todos los pacientes que solicitaron atención medica de noviembre de 2018 a enero de 2019. Se clasificaron de acuerdo con el ritmo reportado para después comparar los ritmos por tipo de electrocardiograma.
Resultados: Se incluyeron 100 pacientes, 48 hombres y 52 mujeres; con edad entre 20 y 90 años, con promedio de 39.4 ± 2.0 años. Tres cardiólogos independientes determinaron el ritmo, características de los segmentos y dieron una impresión diagnóstica global. Entre ellos el valor de Kappa general fue de 0.81 (p = 0.000). Con respecto a la capacidad de la detección del ritmo se encontró concordancia del 100% N95 (p = 0.00) para la detección del ritmo con la electrocardiografía celular inalámbrica, sin encontrar diferencia con el patrón de referencia que es el electrocardiograma de 12 derivaciones.
Conclusiones: Con la electrocardiografía de una derivación utilizando un cardiochip es posible de manera clínicamente significativa grabar y traducir el ritmo cardiaco.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Whitehead L, Seaton P. The effectiveness of self-management mobile phone and tablet apps in long-term condition management: A systematic review. J Med Internet Res 2016; 18 (5): e97. doi. 10.2196/jmir.4883.

2. Pew Research Center. Mobile Fact Sheet; 2017. Available from: http://www.pewinternet.org/fact-sheet/mobile/. Accessed August 30, 2017.

3. Guzik P, Malik M. ECG by mobile technologies. J Electrocardiol 2016; 49 (6): 894-901. doi. 10.1016/j.jelectrocard. 2016.07.030.

4. Maurizi N, Faragli A, Imberti J, Briante N, et al. Cardiovascular screening in low-income settings using a novel 4-lead smartphone-based electrocardiograph (DHeart ®). Int J Cardiol 2017; 236: 249-252. doi. 10.1016/j. ijcard.2017.02.027.

5. Maurizi N, Fumagalli C, Targetti M, Passantino S, et al. 217 Comparative analysis of multiple leads smartphone electrocardiograph versus standard 12-leads electrocardiograph in patients with hypertrophic cardiomyopathy. EP Europace 2018; 20 (suppl_1): i26. https://doi.org/10.1093/ europace/euy015.066.

6. Karijo E. Testing low-cost portable smartphone electrocardiographs in the screening of pregnant women in Mwingi West and Mwingi Central, Kitui County, Kenya; 2016. Available from: https://docs.wixstatic.com/ugd/5cb79f_2 7fe047906794f2dbe5a0c500defb369.pdf.

7. Lim MCL, Lim I, Devaraj LM. Qualitative and quantitative accuracy of a novel multi-lead mobile phone ECG. Eur Heart J Suppl 2010; 12 (suppl_A): S26.

8. Lim M, Lin Z, Michael L. ASSA13-07-1 Comparison of the ECG recordings using a novel mobile ECG recorder (EPI Mini) with a clinically validated mobile phone with ECG recording function (EPI Life). Presented at: Annual Scientific Sessions of APHA. Singapore; 2013. Available from: http:// epimhealth.com/images/pdf/Abstract-ASSA13-07-1.pdf. Accessed January 16, 2018.

9. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 2004; 110 (9): 1042-1046. doi. 10.1161/01.CIR.0000140263.20897.42.

10. Borowsky LH, Regan S, Chang Y, Ayres A, et al. First diagnosis of atrial fibrillation at the time of stroke. Cerebrovasc Dis 2017; 43 (3-4): 192-199. doi. 10.1159/000457809.

11. Hobbs FD, Fitzmaurice DA, Mant J, Murray E, et al. A randomised controlled trial and cost-effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in people aged 65 and over. The SAFE study. Health Technol Assess 2005; 9 (40): iii-iv, ix-x, 1-74. doi. 10.3310/hta9400.

12. Lau JK, Lowres N, Neubeck L, Brieger DB, et al. iPhone ECG application for community screening to detect silent atrial fibrillation: a novel technology to prevent stroke. Int J Cardiol 2013; 165 (1): 193-194. doi. 10.1016/j. ijcard.2013.01.220.

13. Orchard J, Lowres N, Freedman SB, Ladak L, et al. Screening for atrial fibrillation during influenza vaccinations by primary care nurses using a smartphone electrocardiograph (iECG): A feasibility study. Eur J Prev Cardiol 2016; 23 (2 suppl): 13-20. doi. 10.1177/2047487316670255.

14. Chan N-Y, Choy C-C. Screening for atrial fibrillation in 13 122 Hong Kong citizens with smartphone electrocardiogram. Heart 2017; 103 (1): 24-31. doi. 10.1136/ heartjnl-2016-309993

15. Lowres N, Neubeck L, Salkeld G, Krass I, et al. Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. The SEARCH-AF study. Thromb Haemost 2014; 111 (6): 1167-1175. doi. 10.1160/TH14-03-0231.

16. Treskes RW, Gielen W, Wermer MJ, Grauss RW, et al. Mobile phones in cryptogenic strOke patients Bringing sIngle Lead ECGs for Atrial Fibrillation detection (MOBILE-AF): study protocol for a randomised controlled trial. Trials 2017; 18 (1): 402. doi. 10.1186/s13063-017-2131-0.

17. Hendrikx T, Rosenqvist M, Wester P, Sandström H, et al. Intermittent short ECG recording is more effective than 24- hour Holter ECG in detection of arrhythmias. BMC Cardiovasc Disord 2014; 14: 41. doi. 10.1186/1471-2261-14-41.

18. Fetsch T, Bauer P, Engberding R, et al. Prevention of atrial fibrillation after cardioversion: results of the PAFAC trial. Eur Heart J 2004; 25 (16): 1385-1394. doi. 10.1016/j. ehj.2004.04.015.

19. Tarakji KG, Wazni OM, Callahan T, et al. Using a novel wireless system for monitoring patients after the atrial fibrillation ablation procedure: the iTransmit study. Heart Rhythm 2015; 12 (3): 554-559. doi. 10.1016/j.hrthm.2014.11.015.

20. January CT, Wann LS, Alpert JS, Calkins H, et al. 2016 AHA/ ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014; 130 (23): 2071-2104. https://doi. org/10.1161/CIR.0000000000000040.

21. Chung EH, Guise KD. QTc intervals can be assessed with the AliveCor heart monitor in patients on dofetilide for atrial fibrillation. J Electrocardiol 2015; 48 (1): 8-9.

22. Garabelli P, Stavrakis S, Albert M, Koomson E, et al. Comparison of QT interval readings in normal sinus rhythm between a smartphone heart monitor and a 12-lead ECG for healthy volunteers and inpatients receiving sotalol or dofetilide. J Cardiovasc Electrophysiol 2016; 27 (7): 827- 832. doi. 10.1111/jce.12976.

23. Hickey KT, Hauser NR, Valente LE, Riga TC, et al. A singlecenter randomized, controlled trial investigating the efficacy of a mHealth ECG technology intervention to improve the detection of atrial fibrillation: the iHEART study protocol. BMC Cardiovasc Disord 2016; 16: 152. doi. 10.1186/s12872-016-0327-y.

24. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, et al. Heart Disease and Stroke Statistics-2016 Update: A Report from the American Heart Association. Circulation 2016; 133 (4): e38-e360. doi. 10.1161/CIR.0000000000000350.

25. Muhlestein JB, Le V, Albert D, et al. Smartphone ECG for evaluation of STEMI: results of the ST LEUIS Pilot Study. J Electrocardiol 2015; 48 (2): 249-259. doi. 10.1016/j.jelectrocard. 2014.11.005.