Evaluating the Diagnostic Accuracy of Reduced Lead Paediatric Electrocardiograms
Document Type
Article
Publication Title
Cardiology in the Young
Abstract
Introduction: Alternate electrocardiogram acquisition with fewer leads lacks systematic evaluation in children. This study aims to determine if electrocardiograms with fewer leads maintain diagnostic accuracy in paediatrics.
Methods: This is a single-centre review of 200 randomly selected standard 12-lead electrocardiograms from our hospital database (2017-2020) for patients aged 2 weeks to 21 years. An overlay technique generated 8-lead (limb + V1/V6) and 6-lead (limb only) variations of the 12-lead tracings, resulting in a total of 600 electrocardiograms, which were then interpreted by two independent paediatric electrophysiologists.
Results: In total, 18% (35/200) of the baseline electrocardiograms were abnormal. Intervals were measured in lead II for all electrocardiograms. Comparing 12-lead to 6- and 8-lead electrocardiograms, there was almost perfect agreement for specific rhythm identification (97.5-100%, κ 0.85-1). The 8-lead showed substantial agreement with 12-lead electrocardiograms when identifying specific electrocardiogram patterns (97.5-100%, κ 0.66-1). A similar degree of agreement was not demonstrated with the 6-lead variant. Utilising the 12-lead electrocardiogram as the gold standard, sensitivity and specificity of the 8- and 6-lead electrocardiogram were > 89% for specific rhythm identification. Specificity for specific pattern recognition was > 99% while sensitivity was < 90% for certain variables for both 6- and 8-lead electrocardiogram, likely due to smaller sample size and fewer abnormal electrocardiograms. There was high percent reader agreement (92.5-100%).
Conclusions: 8-lead electrocardiograms provide comparable diagnostic accuracy to 12-lead electrocardiograms for children. This information holds potential for future technological advancements in electrocardiogram acquisition tailored specifically for paediatrics. Additional studies are required to further refine conventional electrocardiogram acquisition.
DOI
10.1017/S1047951124036023
Publication Date
12-11-2024
Keywords
Electrocardiogram, electrophysiology, paediatric cardiology, reduced lead electrocardiogram, technological advancements
ISSN
1467-1107
Recommended Citation
Damera MC, Centanni R, Sherman A, Kline J, Follansbee CW, Chang PM, Malloy-Walton L. Evaluating the Diagnostic Accuracy of Reduced Lead Paediatric Electrocardiograms. Cardiology in the Young. 2024; . doi: 10.1017/S1047951124036023.
