ECG-based signal analysis technologies for evaluating patients with acute coronary syndrome: A systematic review

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• 作者：Philip J. Leisy ; BS^a ; ^b ; Remy R. Coeytaux ; MD ; PhD^a ; ^c ; ^{remy.coeytaux@duke.edu} ; Galen S. Wagner ; MD^d ; Eugene H. Chung ; MD ; MSc^e ; Amanda J. McBroom ; PhD^a ; Cynthia L. Green ; PhD^f ; John W. Williams Jr. ; MD ; MHS^a ; ^g ; Gillian D. Sanders ; PhD^a ; ^d
• 关键词：Electrocardiography ; Acute coronary syndrome ; ECG-based signal analysis
• 刊名：Journal of Electrocardiology
• 出版年：2013
• 出版时间：March-April, 2013
• 年：2013
• 卷：46
• 期：2
• 页码：92-97
• 全文大小：221 K

文摘

Background/Objectives

Timely identification of cardiac ischemia is critical in patients with acute coronary syndrome (ACS). The first test is often the standard, resting 12-lead ECG. Given its limitations, signal analysis enhancements have been proposed. We summarize the published evidence for commercially available ECG-based signal analysis technologies.

Methods

This is a systematic review of the English-language published literature.

Results

Published evidence meeting inclusion criteria was available for two devices: PRIME ECG and LP 3000. Meta-analysis of eight studies estimated a 68.4 % sensitivity (95 % CI, 35.1 % -89.7 % ) and 91.4 % specificity (CI, 83.6 % -95.7 % ) for the PRIME ECG, compared with 40.5 % sensitivity (CI, 19.6 % -65.5 % ) and 95.0 % specificity (CI, 87.9 % -98.0 % ) for the standard 12-lead ECG.

Conclusions

Existing evidence is insufficient to confidently inform the appropriate use of ECG-based signal analysis technologies for detecting ischemia or infarct in ACS. Further research is needed to determine in what circumstances, if any, these devices might precede, replace, or add to the standard ECG in test strategies for detecting ischemia or infarct in ACS.