TY  - JOUR
AU  - Shvilkin, Alexei
AU  - Vukajlović, Dejan
AU  - Bojović, Boško P.
AU  - Hadžievski, Ljupčo
AU  - Vajdic, Branislav
AU  - Atanasoski, Vladimir
AU  - Miletić, Marjan
AU  - Zimetbaum, Peter J.
AU  - Gibson, C. Michael
AU  - Vukčević, Vladan
PY  - 2023
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/12393
AB  - Background Early coronary occlusion detection by portable personal device with limited number of electrocardiographic (ECG) leads might shorten symptom-to-balloon time in acute coronary syndromes.  Objectives The purpose of this study was to compare the accuracy of coronary occlusion detection using vectorcardgiographic analysis of a near-orthogonal 3-lead ECG configuration suitable for credit card-size personal device integration with automated and human 12 lead ECG interpretation.  Methods The 12-lead ECGs with 3 additional leads (“abc”) using 2 arm and 2 left parasternal electrodes were recorded in 66 patients undergoing percutaneous coronary intervention prior to (“baseline”, n = 66), immediately before (“preinflation”, n = 66), and after 90-second balloon coronary occlusion (“inflation”, n = 120). Performance of computer-measured ST-segment shift on vectorcardgiographic loops constructed from “abc” and 12 leads, standard 12-lead ECG, and consensus human interpretation in coronary occlusion detection were compared in “comparative” and “spot” modes (with/without reference to “baseline”) using areas under ROC curves (AUC), reliability, and sensitivity/specificity analysis.  Results Comparative “abc”-derived ST-segment shift was similar to two 12-lead methods (vector/traditional) in detecting balloon coronary occlusion (AUC = 0.95, 0.96, and 0.97, respectively, P = NS). Spot “abc” and 12-lead measurements (AUC = 0.72, 0.77, 0.68, respectively, P = NS) demonstrated poorer performance (P < 0.01 vs comparative measurements). Reliability analysis demonstrated comparative automated measurements in “good” agreement with reference (preinflation/inflation), while comparative human interpretation was in “moderate” range. Spot automated and human reading showed “poor” agreement.  Conclusions Vectorcardiographic ST-segment analysis using baseline comparison of 3-lead ECG system suitable for credit card-size personal device integration is similar to established 12-lead ECG methods in detecting balloon coronary occlusion.
T2  - JACC: Advances
T1  - Coronary Artery Occlusion Detection Using 3-Lead ECG System Suitable for Credit Card-Size Personal Device Integration
VL  - 2
IS  - 6
SP  - 100454
DO  - 10.1016/j.jacadv.2023.100454
ER  - 

@article{
author = "Shvilkin, Alexei and Vukajlović, Dejan and Bojović, Boško P. and Hadžievski, Ljupčo and Vajdic, Branislav and Atanasoski, Vladimir and Miletić, Marjan and Zimetbaum, Peter J. and Gibson, C. Michael and Vukčević, Vladan",
year = "2023",
abstract = "Background Early coronary occlusion detection by portable personal device with limited number of electrocardiographic (ECG) leads might shorten symptom-to-balloon time in acute coronary syndromes.  Objectives The purpose of this study was to compare the accuracy of coronary occlusion detection using vectorcardgiographic analysis of a near-orthogonal 3-lead ECG configuration suitable for credit card-size personal device integration with automated and human 12 lead ECG interpretation.  Methods The 12-lead ECGs with 3 additional leads (“abc”) using 2 arm and 2 left parasternal electrodes were recorded in 66 patients undergoing percutaneous coronary intervention prior to (“baseline”, n = 66), immediately before (“preinflation”, n = 66), and after 90-second balloon coronary occlusion (“inflation”, n = 120). Performance of computer-measured ST-segment shift on vectorcardgiographic loops constructed from “abc” and 12 leads, standard 12-lead ECG, and consensus human interpretation in coronary occlusion detection were compared in “comparative” and “spot” modes (with/without reference to “baseline”) using areas under ROC curves (AUC), reliability, and sensitivity/specificity analysis.  Results Comparative “abc”-derived ST-segment shift was similar to two 12-lead methods (vector/traditional) in detecting balloon coronary occlusion (AUC = 0.95, 0.96, and 0.97, respectively, P = NS). Spot “abc” and 12-lead measurements (AUC = 0.72, 0.77, 0.68, respectively, P = NS) demonstrated poorer performance (P < 0.01 vs comparative measurements). Reliability analysis demonstrated comparative automated measurements in “good” agreement with reference (preinflation/inflation), while comparative human interpretation was in “moderate” range. Spot automated and human reading showed “poor” agreement.  Conclusions Vectorcardiographic ST-segment analysis using baseline comparison of 3-lead ECG system suitable for credit card-size personal device integration is similar to established 12-lead ECG methods in detecting balloon coronary occlusion.",
journal = "JACC: Advances",
title = "Coronary Artery Occlusion Detection Using 3-Lead ECG System Suitable for Credit Card-Size Personal Device Integration",
volume = "2",
number = "6",
pages = "100454",
doi = "10.1016/j.jacadv.2023.100454"
}

Shvilkin, A., Vukajlović, D., Bojović, B. P., Hadžievski, L., Vajdic, B., Atanasoski, V., Miletić, M., Zimetbaum, P. J., Gibson, C. M.,& Vukčević, V.. (2023). Coronary Artery Occlusion Detection Using 3-Lead ECG System Suitable for Credit Card-Size Personal Device Integration. in JACC: Advances, 2(6), 100454.
https://doi.org/10.1016/j.jacadv.2023.100454

Shvilkin A, Vukajlović D, Bojović BP, Hadžievski L, Vajdic B, Atanasoski V, Miletić M, Zimetbaum PJ, Gibson CM, Vukčević V. Coronary Artery Occlusion Detection Using 3-Lead ECG System Suitable for Credit Card-Size Personal Device Integration. in JACC: Advances. 2023;2(6):100454.
doi:10.1016/j.jacadv.2023.100454 .

Shvilkin, Alexei, Vukajlović, Dejan, Bojović, Boško P., Hadžievski, Ljupčo, Vajdic, Branislav, Atanasoski, Vladimir, Miletić, Marjan, Zimetbaum, Peter J., Gibson, C. Michael, Vukčević, Vladan, "Coronary Artery Occlusion Detection Using 3-Lead ECG System Suitable for Credit Card-Size Personal Device Integration" in JACC: Advances, 2, no. 6 (2023):100454,
https://doi.org/10.1016/j.jacadv.2023.100454 . .