AHA 2018: Study shows AliveCor phone app can effectively identify STEMI with nearly the same accuracy as a standard ECG

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AliveCor

An international study, led by researchers from the Intermountain Medical Center Heart Institute in Salt Lake City, found that a smartphone app (AliveCor) to monitor heart activity and determine if someone is having an ST-segment elevation myocardial infarction (STEMI) has nearly the same accuracy as a standard 12-lead ECG.

In the study, 204 patients with chest pain received both a standard 12-lead ECG and an ECG through the AliveCor app, which is administered through a smartphone with a two-wire attachment.

Brent Muhlestein (Intermountain Medical Center Heart Institute, Murray, USA) and colleagues found the app with the wire set-up was effective in distinguishing STEMI from not-STEMI ECGs accurately and with high sensitivity compared to a traditional 12-lead ECG. Muhlestein presented the data at the 2018 American Heart Association’s 2018 Scientific Session (10–12 November, Chicago, USA).

The findings of the study are important for two reasons, says Muhlestein. He explains that the first is it could speed up the urgent treatment a patient needs after experiencing a STEMI, commenting: “If somebody gets chest pain and they have not ever had chest pain before, they might think it is just a bug or it is gas and they will not go to the emergency room. That is dangerous, because the faster we open the blocked artery, the better the patient’s outcome will be”.

The app can take the electrocardiogram on the spot, send the results into the cloud where a cardiologist reviews it immediately and, if a STEMI is found, tell the person so they can be rushed to the hospital.

The second key benefit is that the price of the app with the two-wire extension is low, which could put the power of an ECG into the hands of anyone with a smartphone or smartwatch, and make ECGs accessible in places like third world countries where people have smartphones but where expensive ECG machines are hard to find, if they’re available at all.

The idea for this kind of ECG set-up perhaps came from the use of treadmills for personal fitness development, notes Muhlestein. Many people using treadmills wear a simple device that can detect their heart rate, through a single ECG lead, more accurate than just checking the pulse. “It is a simple jump from there to putting it on a smartphone, and then recording the same ECG lead from several body positions,” he says.

The new Apple 4 smartwatch also comes with a single-lead ECG. With the AliveCor app, the two wire leads are moved around the body in order to record all 12 parts.

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