Journal of Tehran University Heart Center (Jan 2008)
Value of Automated ECG Interpretation in Diagnosis of Cardiac Disorders
Abstract
Background: Electrocardiography (ECG) is a valuable device in the assessment of cardiovascular diseases. Recent medical software developments such as the invention of modern automated ECG interpreters have greatly facilitated the work of electrocardiographers and cardiologists. We present our experience in the use of one such device in the routine reporting of 200 successive ECGs recorded in our Cardiac Care Unit and Cardiac Emergency Ward. Methods: The interpretations of 200 ECGs provided by the GE-digital ECG device were chosen and compared with those supplied by four cardiologists in a single blind manner. All statistical analyses were performed by using SPSS version 11.5 for windows. A p value of less than 0.05 was considered statistically significant. Results: There was a diagnostic match between the interpretations by the device and those by the cardiologists in 107 (53.5%) cases as opposed to a diagnostic mismatch in 93 cases (46.5%). The matching rate in the interpretations of myocardial ischemic disorders was high, which means practically all the ischemic cases diagnosed by the device were confirmed by the cardiologists. Only in 12 cases myocardial infarction or ischemic changes were reported by the cardiologists, while they were missed by the device. As regards rhythm disorders, the sensitivity and specificity of the device were 67.7% and 75.7%, respectively. With respect to conductive disorders, the respective sensitivity and specificity of the device were 70% and 96.6%, respectively. Finally, in the case of structural disorders, the interpretations of the device were 92.8% sensitive and 83.3% specific. Conclusion: According to the results of our study and similar researches, it seems that the interpretations of an automated ECG device in diagnosing the ischemic and structural disorders of the heart are reliable. The device, however, should not be relied upon when assessing conduction disorders and dysrhythmias. We, therefore, recommend that the users of digital ECG devices recheck the digital interpretations in those cases.
