4-lead phone-based ECG could improve cardiovascular diagnostics in low-income countries

The D-Heart, manufactured by Genova, Italy-based D-Heart Srl, developed a four-lead smartphone-based electrocardiogram (ECG). It is compatible with both iOS and Android operating systems and can stream results to any smartphone via Bluetooth.

The team’s work was published in the International Journal of Cardiology. The D-Heart is pocket size, relatively affordable and can be tailored for the patient, which could allow use in poor, rural settings.

“In general, low- and middle-income countries have major restrictions on their healthcare capacities due to the lack of infrastructures, human resources and logistics,” wrote lead author Niccol√≤ Maurizi, cofounder of D-Hear, and colleagues. “Smartphone technology may overcome several of these limitations by providing an easy and affordable access to accurate diagnostic and monitoring methods.”

The study featured 117 patients in Senegal, African. The mean age was 39 years old, with men accounting for 59 percent of participants. Only eight patients had been diagnosed with hypertension and five had a history or coronary artery disease.

The two ECG tracings were classified as normal (72 for D-Heart, 69 for 12-lead ECG), mildly abnormal (42 and 45) and moderately abnormal (3 and 3). Agreement was achieved in 116 of 117 cases with D-Heart tracings and 115 of 117 cases with the standard ECG.

The 12-lead ECG was more sensitive to abnormalities, but D-Heart achieved 100 percent concordance for moderately abnormal tracings.

“Novel smartphone-based techniques open promising perspectives for low-cost cardiovascular screening programs,” wrote Maurizi et al. “Further studies are clearly needed to assess if these theoretical advantages are supported by patient-centered outcomes and positive cost-benefit analysis.”

Of note, the present study was based on a low-risk patient cohort, with limited prevalence of abnormal tracings, as would be expected in a young community-based African population.