Telemetry control and self control of electrocardiogram. A new perspective on preventive and clinical cardiology
E. V. Zemtsovsky1, А. М. Konobasov2, Т. V. Treshkur1, Е. А. Tsurinova1, S. V. Popov1, M. M. Homich1
1 - Almazov Federal Heart, Blood and Endocrinology Centre, St.-Petersburg, Russia
2 - The Сlosed Joint-Stock Company "МICARD-LANA", St.-Petersburg, Russia
Introduction. Despite the high demand for telemetry method of recording and analyzing 12-lead electrocardiogram (ECG), its use remains the prerogative of a physician. The reason is assumed to be that the ECG requires special medical training. All the existing telemetry system use a modified overlay limb electrodes, ECG transmission distance consultancy centers (DCC), which hosted four-hour duty professionals, which makes the ECG telemetry costly and difficult procedure available. Capabilities of Internet technologies and computer ECG diagnosis of the existing instruments are not used.
Objective. Clinical trials of a fundamentally new open system of telemetric ECG control and self-control called “Cardiometr”, providing the possibility to transfer the telemetry 12-lead ECG and offering open access to ECG archive for both the patient and the specialist cardiologist.
Results. In the process of clinical trials by physicians and patients 520 ECG were recorded and transmitted to the server. In addition, the results of automated and clinical analysis of 998 ECG captured in ambulatory patients were compared. Clinical trials have proved that the “Cardiometr” remote information device (RID) allows to register a 12-lead ECG, send it via Bluetooth to a mobile phone or a personal computer (PC) having Internet access. Next, the ECG via telephone or the PC could be sent to the server, where it is processed by the computer software and stored in the archive files sorted by registered patients or doctors. The preliminary conclusion on the results of automated processing mode “normal, abnormal, pathologic” [traffic lights mode] can be sent to a mobile phone as a brief conclusion (special option). Is also possible to print 12-lead ECG as a graphic of typical complexes and a long strip of ECG in one of the leads. A consulting physician with access to the archive ECG patient has the opportunity to study ECGs taken at different times and thus make a comparative analysis. The doctor gets the results of automatic processing of the ECG and, if necessary, may make adjustments to the conclusion. Experience of recording ECGs showed the convenience and easiness of RID usage, the high quality of the ECG recording. Comparison of the results revealed that the analysis of heart rate findings from the automatic analysis, in 93,7% cases coincide with those of physicians. Only in one case (0.1% of cases) the rhythm of the automatic analysis was wrongly classified as pathological. In 97.8% of patients with abnormal cardiac rhythm (atrial fibrillation, frequent premature beats) a complete coincidence of automatical and manned findings was observed. Slightly worse were results of the comparison of the automatic analysis and physician evaluation of the complex shape PQRST. Here, in 4 out of 998 cases of the computer analysis did not detect pathological changes PQRST, while another 13% of ECGs were considered abnormal, whereas the physician assessed them as a variant of the norm. In general, these results can be considered rather acceptable, since the conclusions made by the computer must be checked by a physician.
Conclusion. Using an open system telemetry control and self-control of ECG “Cardiometr” provides new possibilities in prevention and early diagnostic of cardiac pathology.