In 10 Dutch general practices, KardiaMobile ECG and AF algorithm were compared with simultaneous 12-lead ECG. Three cardiologists reviewed ECG data from 214 patients (mean age 64.1 y, 54% male). The 12-lead ECG diagnosed AF/AFL, any rhythm abnormality, and any conduction abnormality (AV block, BBB, LAD, LAFB) in 23, 44, and 28 patients, respectively. KardiaMobile ECG as assessed by the cardiologists had a sensitivity and specificity for AF/AFL of 100% (95% CI, 85.2%-100%) and 100% (95% CI, 98.1%-100%). The AF Instant Analysis algorithm identified 20 or 23 AF cases and incorrectly classified 4 cases of sinus rhythm as possible AF (sensitivity and specificity of 87.0% (95% CI, 66.4%-97.2%) and 97.9% (95% CI, 94.7%-99.4%)). KardiaMobile recordings as assessed by cardiologists had a sensitivity and specificity for any rhythm abnormality of 90.9% (95% CI, 78.3%-97.5%) and 93.5% (95% CI, 88.7%-96.7%) and for any conduction abnormality of 46.4% (95% CI, 27.5%-66.1%) and 100% (95% CI, 98.0%-100%). For conduction abnormality, the 15 false negatives were comprised of first-degree AVB (n=6), LAFB (n=8), and RBBB (n=1); on the other hand, cardiologists were able to accurately identify BBB in 13 patients’ KardiaMobile ECGs. The authors concluded that in a primary care population, the KardiaMobile ECG recording showed excellent diagnostic accuracy for AF/AFL and good diagnostic accuracy for other rhythm abnormalities. The 1L-ECG device was less sensitive for left anterior fascicular block and first-degree AV block.
Ann Fam Med. 2019;17: 403-11.