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Session: Heart
Session starts: Thursday 26 January, 10:30
Presentation starts: 11:00
Room: Room 558

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Alejandra Zepeda-Echavarria (UMC Utrecht)
Rutger van de Leur (UMC Utrecht)
Nynke de Vries (UMC Utrecht)
Rien van der Zee (Stichting Cardiovasculaire Biologie)
Joris Jaspers (UMC Utrecht)
Thierry Wildbergh (Meander Medical Center)
Pieter Doevendans (UMC Utrecht)
René van Es (UMC Utrecht)

Abstract:
The ECG is a fundamental diagnostic tool in the everyday practice of clinical medicine. The 12-lead ECG is commonly used by physicians to diagnose, monitor, record and understand the electrical activity of the heart. Technological advances have allowed to bring medical devices to home environments. To investigate if an arrangement of 4- precordial electrodes could provide enough evidence to detect ECG changes, we developed a smartphone-sized ECG recording device, the miniECG, aiming to detect the full spectrum of ECG abnormalities. The miniECG has the following components: four dry electrodes, a microcontroller unit, and an app. The four electrodes are stainless steel electrodes with peaks that could enable a low impedance contact. The design of the microcontroller unit is based on the ADS1298 (Texas Instruments, USA). Eight differential channels are recorded for 10 seconds, with a 24-bit resolution and a programmable gain up to 12V/V. The recordings and connection to app via Bluetooth is managed by the microcontroller NRF52840 (Nordic Semiconductor, Norway) featuring an Arm® Cortex ® -M4F CPU. The app designed to start and collect data on the recordings was designed on React Native. Finally, the high-level software for the processing and visualization of the ECG data was developed in python. A first clinical study to determine if the miniECG is capable to detect ST-elevation was performed from May 2021 to February 2022 at UMC Utrecht and Meander Medical Center. A total of 252 patients were included, 36 of whom demonstrated ST-elevation at hospital arrival. In 30 of these patients the ST-elevation was also present on the miniECG recordings while in 2 patients ST-elevation had resolved on the follow up 12 lead ECG and the other 4 ST-elevation was not present on miniECG recordings. Further analysis showed that the miniECG can record anterior, lateral, and inferior ST-elevation. The miniECG can record high-quality multi-lead ECGs. Analysis of clinical study data shows that the miniECG can accurately detect ischemic ST-elevation in patients with inferior, lateral, and anterior myocardial infarction. Further research is required to demonstrate non-inferiority of the miniECG to the standard 12-lead ECG in the detection of other common cardiac (ab)normalities.