scholarly journals Recording of Bipolar Multichannel ECGs by a Smartwatch: Modern ECG Diagnostic 100 Years after Einthoven

Sensors ◽  
2019 ◽  
Vol 19 (13) ◽  
pp. 2894 ◽  
Author(s):  
Alexander Samol ◽  
Kristina Bischoff ◽  
Blerim Luani ◽  
Dan Pascut ◽  
Marcus Wiemer ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Index Finger ◽  
Left Index Finger ◽  
Signal Quality ◽  
Lower Abdomen ◽  
Left Wrist ◽  
Cardiac Disorders ◽  
The Right ◽  
Erroneous Assignment ◽  
Repolarization Abnormalities

Aims: Feasibility study of accurate three lead ECG recording (Einthoven I, II and III) using an Apple Watch Series 4. Methods: In 50 healthy subjects (18 male; age: 40 ± 12 years) without known cardiac disorders, a 12-lead ECG and three bipolar ECGs, corresponding to Einthoven leads I, II and III were recorded using an Apple Watch Series 4. Einthoven I was recorded with the watch on the left wrist and the right index finger on the crown, Einthoven II with the watch on the left lower abdomen and the right index finger on the crown, Eindhoven III with the watch on the left lower abdomen and the left index finger on the crown. Four experienced cardiologists were independently asked to assign the watch ECGs to Einthoven leads from 12-lead ECG for each subject. Results: All watch ECGs showed an adequate signal quality with 134 ECGs of good (89%) and 16 of moderate signal quality (11%). Ninety-one percent of all watch ECGs were assigned correctly to corresponding leads from 12-lead ECG. Thirty-nine subjects (78%) were assigned correctly by all cardiologists. All assignment errors occurred in patients with similar morphologies and amplitudes in at least two of the three recorded leads. Erroneous assignment of all watch ECGs to leads from standard ECG occurred in no patient. Conclusion: Recording of Einthoven leads I-III by a smartwatch is accurate and highly comparable to standard ECG. This might contribute to an earlier detection of cardiac disorders, which are associated with repolarization abnormalities or arrhythmias.

scholarly journals Feasibility and Reliability of SmartWatch to Obtain 3-Lead Electrocardiogram Recordings

Sensors ◽  
2020 ◽  
Vol 20 (18) ◽  
pp. 5074
Author(s):  
Amirali Behzadi ◽  
Alireza Sepehri Shamloo ◽  
Konstantinos Mouratis ◽  
Gerhard Hindricks ◽  
Arash Arya ◽  
...  
Keyword(s):  
Data Analysis ◽  
Large Study ◽  
Index Finger ◽  
Left Index Finger ◽  
Spearman Correlation ◽  
Lower Abdomen ◽  
Left Wrist ◽  
The Right ◽  
Ecg Leads ◽  
Electrocardiogram Ecg

Some of the recently released smartwatch products feature a single-lead electrocardiogram (ECG) recording capability. The reliability of obtaining 3-lead ECG with smartwatches is yet to be confirmed in a large study. This study aimed to assess the feasibility and reliability of smartwatch to obtain 3-lead ECG recordings, the classical Einthoven ECG leads I-III compared to standard ECG. To record lead I, the watch was worn on the left wrist and the right index finger was placed on the digital crown for 30 s. For lead II, the watch was placed on the lower abdomen and the right index finger was placed on the digital crown for 30 s. For lead III, the same process was repeated with the left index finger. Spearman correlation and Bland-Altman tests were used for data analysis. A total of 300 smartwatch ECG tracings were successfully obtained. ECG waves’ characteristics of all three leads obtained from the smartwatch had a similar duration, amplitude, and polarity compared to standard ECG. The results of this study suggested that the examined smartwatch (Apple Watch Series 4) could obtain 3-lead ECG tracings, including Einthoven leads I, II, and III by placing the smartwatch on the described positions.

scholarly journals Single-Lead ECG Recordings Including Einthoven and Wilson Leads by a Smartwatch: A New Era of Patient Directed Early ECG Differential Diagnosis of Cardiac Diseases?

Sensors ◽  
2019 ◽  
Vol 19 (20) ◽  
pp. 4377 ◽  
Author(s):  
Alexander Samol ◽  
Kristina Bischof ◽  
Blerim Luani ◽  
Dan Pascut ◽  
Marcus Wiemer ◽  
...  
Keyword(s):  
Index Finger ◽  
Intercostal Space ◽  
Left Index Finger ◽  
Signal Quality ◽  
Cardiac Diseases ◽  
Lower Abdomen ◽  
Anterior Myocardial Infarction ◽  
Left Hand ◽  
Good Signal ◽  
The Right

Background: Smartwatches that are able to record a bipolar ECG and Einthoven leads were recently described. Nevertheless, for detection of ischemia or other cardiac diseases more leads are required, especially Wilson’s chest leads. Objectives: Feasibility study of six single-lead smartwatch (Apple Watch Series 4) ECG recordings including Einthoven (I, II, III) and Wilson-like pseudo-unipolar chest leads (Wr, Wm, Wl). Methods: In 50 healthy subjects (16 males; age: 36 ± 11 years, mean ± SD) without known cardiac disorders, a standard 12-lead ECG and a six single-lead ECG using an Apple Watch Series 4 were performed under resting conditions. Recording of Einthoven I was performed with the watch on the left wrist and the right index finger on the crown, Einthoven II was recorded with the watch on the left lower abdomen and the right index finger on the crown, Einthoven III was recorded with the watch on the left lower abdomen and the left index finger on the crown. Wilson-like chest leads were recorded corresponding to the locations of V1 (Wr), V4 (Wm) and V6 (Wl) in the standard 12-lead ECG. Wr was recorded in the fourth intercostal space right parasternal, Wm was recorded in the fifth intercostal space on the midclavicular line, and Wl was recorded in the fifth intercostal space in left midaxillary line. For all Wilson-like chest lead recordings, the smartwatch was placed on the described three locations on the chest, the right index finger was placed on the crown and the left hand encompassed the right wrist. Both hands and forearms also had contact to the chest. Three experienced cardiologists were independently asked to allocate three bipolar limb smartwatch ECGs to Einthoven I–III leads, and three smartwatch Wilson-like chest ECGs (Wr, Wm, Wl) to V1, V4 and V6 in the standard 12-lead ECG for each subject. Results: All 300 smartwatch ECGs showed a signal quality useable for diagnostics with 281 ECGs of good signal quality (143 limb lead ECGs (95%), 138 chest lead ECGs (92%). Nineteen ECGs had a moderate signal quality (7 limb lead ECGs (5%), 12 chest lead ECGs (8%)). One-hundred percent of all Einthoven and 92% of all Wilson-like smartwatch ECGs were allocated correctly to corresponding leads from 12-lead ECG. Forty-six subjects (92%) were assigned correctly by all cardiologists. Allocation errors were due to similar morphologies and amplitudes in at least two of the three recorded Wilson-like leads. Despite recording with a bipolar smartwatch device, morphology of all six leads was identical to standard 12-lead ECG. In two patients with acute anterior myocardial infarction, all three cardiologists recognized the ST-elevations in Wilson-like leads and assumed an occluded left anterior descending coronary artery correctly. Conclusion: Consecutive recording of six single-lead ECGs including Einthoven and Wilson-like leads by a smartwatch is feasible with good ECG signal quality. Thus, this simulated six-lead smartwatch ECG may be useable for the detection of cardiac diseases necessitating more than one ECG lead like myocardial ischemia or more complex cardia arrhythmias.

scholarly journals Measurement of the QT interval using the Apple Watch

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Carmen Anna Maria Spaccarotella ◽  
Serena Migliarino ◽  
Annalisa Mongiardo ◽  
Jolanda Sabatino ◽  
Giuseppe Santarpia ◽  
...  
Keyword(s):  
Qt Interval ◽  
Cardiac Death ◽  
Index Finger ◽  
Clinical Impact ◽  
Altman Analysis ◽  
Lower Abdomen ◽  
Left Wrist ◽  
Qt Intervals ◽  
The Right ◽  
Fourth Intercostal Space

AbstractThe inherited and acquired long QT is a risk marker for potential serious cardiac arrhythmias and sudden cardiac death. Smartwatches are becoming more popular and are increasingly used for monitoring human health. The present study aimed to assess the feasibility and reliability of evaluating the QT interval in lead I, lead II, and V2 lead using a commercially available Apple Watch. One hundred nineteen patients admitted to our Cardiology Division were studied. I, II, and V2 leads were obtained after recording a standard 12-lead ECG. Lead I was recorded with the smartwatch on the left wrist and the right index finger on the crown. Lead II was obtained with the smartwatch on the left lower abdomen and the right index finger on the crown. The V2 lead was recorded with the smartwatch in the fourth intercostal space left parasternal with the right index finger on the crown. There was agreement among the QT intervals of I, II, and V2 leads and the QT mean using the smartwatch and the standard ECG with Spearman’s correlations of 0.886; 0.881; 0.793; and 0.914 (p < 0.001), respectively. The reliability of the QTc measurements between standard and smartwatch ECG was also demonstrated with a Bland–Altman analysis using different formulas. These data show that a smartwatch can feasibly and reliably assess QT interval. These results could have an important clinical impact when frequent QT interval monitoring is required.

scholarly journals Response preparation involves a release of intracortical inhibition in task-irrelevant muscles

2020 ◽  
Author(s):  
Isaac N. Gomez ◽  
Kara Ormiston ◽  
Ian Greenhouse
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Index Finger ◽  
Intracortical Inhibition ◽  
Left Index Finger ◽  
Task Condition ◽  
Response Preparation ◽  
Action Preparation ◽  
The Right ◽  
Task Irrelevant

AbstractAction preparation involves widespread modulation of motor system excitability, but the precise mechanisms are unknown. In this study, we investigated whether intracortical inhibition changes in task-irrelevant muscle representations during action preparation. We used transcranial magnetic stimulation (TMS) combined with electromyography in healthy human adults to measure motor evoked potentials (MEPs) and cortical silent periods (CSPs) in task-irrelevant muscles during the preparatory period of simple delayed response tasks. In Experiment 1, participants responded with the left-index finger in one task condition and the right-index finger in another task condition, while MEPs and CSPs were measured from the contralateral non-responding and tonically contracted index finger. During Experiment 2, participants responded with the right pinky finger while MEPs and CSPs were measured from the tonically contracted left-index finger. In both experiments, MEPs and CSPs were compared between the task preparatory period and a resting intertrial baseline. The CSP duration during response preparation decreased from baseline in every case. A laterality difference was also observed in Experiment 1, with a greater CSP reduction during the preparation of left finger responses compared to right finger responses. MEP amplitudes showed no modulation during movement preparation in any of the three response conditions. These findings indicate cortical inhibition associated with task-irrelevant muscles is transiently released during action preparation and implicate a novel mechanism for the controlled and coordinated release of motor cortex inhibition.New & NoteworthyIn this study we observed the first evidence of a release of intracortical inhibition in task-irrelevant muscle representations during response preparation. We applied transcranial magnetic stimulation to elicit cortical silent periods in task-irrelevant muscles during response preparation and observed a consistent decrease in the silent period duration relative to a resting baseline. These findings address the question of whether cortical mechanisms underlie widespread modulation in motor excitability during response preparation.

Abstract 15680: Validation of Remote Measurement of the Qtc Intervals Using an Apple Watch

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Carmen Spaccarotella ◽  
serena migliarino ◽  
annalisa mongiardo ◽  
Jolanda Sabatino ◽  
Giuseppe Santarpia ◽  
...  
Keyword(s):  
Qt Interval ◽  
Index Finger ◽  
Remote Measurement ◽  
Drug Induced ◽  
Left Wrist ◽  
Qt Interval Prolongation ◽  
The Right ◽  
Health Application ◽  
Pdf Format ◽  
E Mail

Introduction: In many circumstances, especially in the Covid-19 period, it could be necessary to measure the QT interval repeatedly even daily. Hypothesis: The aim of the study was to evaluate the feasibility of remote measuring LI-LII and V2 leads with using a commercially available Apple Watch Series 4. Methods: The accuracy of the QTc calculation with the smartwatch compared to the standard ECG was tested using di!erent formulae. One hundred patients admitted to our CCU were studied. LI-LII and V2 tracings were obtained immediately after the recording of the standard 12-lead ECG. The LI was recorded with the smartwatch on the left wrist and the right index finger on the crown; LII was obtained with the watch on the left lower abdomen and the right index finger on the crown; V2 lead was recorded with a smartwatch in the fourth intercostal space left parasternal with the right index finger on the crown. All recorded 30” ECGs were digitally stored using the health application of an iPhone Series 10 in the pdf format. The advantage of saving the ECG in pdf format is that it can be sent also via e-mail. Results: There was an agreement between the QTLI, QT-LII, QT-V2 and QT mean intervals of smartphone electrocardiography tracings and standard electrocardiography using Spearman’s correlation coefficient of 0.881; 0.885; 0.801; 0.911 respectively [p<0.001]. The reliability of the mean QTc measurements was tested with Bland-Altman analysis using Bazett’s, Friedericia’s, and Framingham’s formulas between standard ECG and smartwatch(Figure). Conclusions: These data demonstrated the feasibility to measure the QTc in LI, LII and V2 leads with a smartwatch with results comparable to that performed with the standard ECG. These data could have an important clinical impact both for the widespread di!usion of smartwatches and for the monitoring of drug-induced QT interval prolongation, especially in the Covid-19 era.

Assessment of Radiation Protection in Hand-Shielding Products With Mini C-Arm Fluoroscopy

Hand ◽  
2019 ◽  
pp. 155894471986593 ◽  
Author(s):  
Matthew B. Cantlon ◽  
Asif M. Ilyas
Keyword(s):  
Radiation Exposure ◽  
Index Finger ◽  
Proximal Phalanx ◽  
Left Index Finger ◽  
Surgical Glove ◽  
Thermoluminescent Dosimeters ◽  
Intraoperative Fluoroscopy ◽  
The Mean ◽  
The Right ◽  
Free Metal

Background: Previous studies have highlighted the particular risk of radiation exposure to the surgeon’s hands with intraoperative fluoroscopy. Although evidence exists that shielding equipment for the hands reduces exposure, the extent of protection is not well understood. Therefore, we set out to determine the degree to which radiation exposure to the surgeon’s hands is decreased with hand-shielding products. Methods: An anthropomorphic model was positioned to simulate a surgeon sitting at a hand table. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. The right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm), whereas the left index finger dosimeter was covered with commercially available hand-shielding products (study arm): lead-free metal-oxide gloves, leaded gloves, and radiation-attenuating cream. Mini fluoroscope position, configuration, and settings were standardized. The model was scanned for 15 continuous minutes in each test run, and each comparative arm was run 3 times. Results: The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8 mrem (range, 30-54) and 18.6 mrem (range, 14-26), respectively. Each hand-shielding product resulted in statistically lower radiation exposure than a single polyisoprene surgical glove. Conclusions: The mean radiation exposure to the hands was significantly decreased when protected by radiation-attenuating options. Each product individually resulted in a statistically significant decrease in hand exposure compared with the control. We recommend that in addition to efforts to decrease radiation exposure, surgeons consider routine use of hand-shielding products when using mini c-arm fluoroscopy.

Music Affects Learning of a Braille-Like Task by Sighted Subjects

1989 ◽  
Vol 69 (3-1) ◽  
pp. 923-929
Author(s):  
Robert F. Kennison ◽  
Richard A. Mcfarland
Keyword(s):  
College Students ◽  
Sensory Input ◽  
Index Finger ◽  
Practical Importance ◽  
Left Index Finger ◽  
Interhemispheric Competition ◽  
Male College ◽  
The Right ◽  
The Brain ◽  
Male College Students

24 consistently right-handed male college students felt sets of four Braille symbols with either the right or the left index finger and identified by touch alone which two of the four symbols in each set were identical. During the task music was played to either the right ear, the left ear, both ears, or neither ear. Significantly fewer errors were made when the music was in the ear contralateral to whichever hand performed the task. The ipsilateral, binaural, and no-music groups did not differ significantly from each other. It is suggested that monaural music to the ear contralateral to the engaged hand led to reduced interhemispheric competition acting on the hemisphere controlling the hand. Such a facilitating effect may be of practical importance in tasks during which one hemisphere receives the bulk of the task-related sensory input and/or processes the final order from the brain to the task-related muscles.

Cortical Representation of Swallowing: A Modified Dual Task Paradigm

2002 ◽  
Vol 94 (3) ◽  
pp. 1029-1040 ◽  
Author(s):  
Stephanie K. Daniels ◽  
David M. Corey ◽  
Cristen L. Barnes ◽  
Nikki M. Faucheaux ◽  
Daniel H. Priestly ◽  
...  
Keyword(s):  
Dual Task ◽  
Right Hemisphere ◽  
Index Finger ◽  
Finger Tapping ◽  
Left Index Finger ◽  
Cortical Representation ◽  
Word Repetition ◽  
Dual Task Paradigm ◽  
Left And Right ◽  
The Right

It is unclear whether the cortical representation of swallowing is lateralized to the left cerebral hemisphere, right hemisphere, or bilaterally represented. As dysphagia is common in acute stroke, it is important to elucidate swallowing lateralization to facilitate earlier detection of stroke patients who may be at greater risk for dysphagia and aspiration. In this study, a modified dual task paradigm was designed to study laterality of swallowing in a group of 14 healthy, young, right-handed, male adults. The subjects were studied at baseline and with interference. Baseline conditions, performed separately, were continuous swallowing, finger tapping using the right and left index fingers, and word repetition. Interference tasks, including tapping with the right index finger, tapping with the left index finger, and word repetition, were completed with and without swallowing. Finger-tapping rate was measured, and x-ray samples of the swallowing task were taped to measure swallowing rate and volume swallowed. At baseline, the rate of tapping the right index finger was significantly faster than that of the left index finger. There was a significant decline in the tapping rates of both left and right index fingers with swallowing interference. The volume per swallow was significantly reduced during the interfering language task of silent repetition. These results offer partial support for a bilateral representation of swallowing as well as suggest an important left hemispheric contribution to swallowing. However, it cannot be concluded that the left hemisphere is more important than the right, as a comparable right hemisphere task was not studied.

Anterior Interosseous Neuropathy in Instrumental Musicians

2006 ◽  
Vol 21 (3) ◽  
pp. 137-141
Author(s):  
Richard J Lederman
Keyword(s):  
Index Finger ◽  
Age At Onset ◽  
Flexor Digitorum Profundus ◽  
Left Index Finger ◽  
Pronator Quadratus ◽  
Motor Branch ◽  
Neuralgic Amyotrophy ◽  
Electrodiagnostic Testing ◽  
The Right ◽  
Flexor Digitorum

The anterior interosseous nerve is a pure motor branch of the median nerve supplying the flexor pollicis longus, flexor digitorum profundus of the index and middle fingers, and pronator quadratus. Anterior interosseous neuropathy is rare and typically causes weakness of flexion of the tips of the thumb and index finger. Four instrumentalists, 3 violinists and 1 pianist (3 males, 1 female), seen from 1986 to 2002 at our clinic, are the subjects of this report. Age at onset ranged from 16 to 76 yrs. A possible precipitating factor was identified in each. One violinist could not hold the bow; two others noted inability to stabilize the distal left first (index) finger. The pianist noted impaired dexterity of the right hand. Examination showed weakness of flexion of the distal phalanx of the index finger and thumb and variable weakness of forearm pronation. Electrodiagnostic testing confirmed the diagnosis in all four patients. All improved over time. One symphony violinist continued to play for over 15 yrs, despite some persisting difficulty with the left index finger. Another violinist recovered function almost completely but suffered a stroke affecting the opposite hand 2.5 years later. The third violinist retired from the symphony on disability because his recovery was delayed for >1 yr. The young pianist is playing 4 to 5 hrs/day. It is likely that at least three of the four had a localized form of neuralgic amyotrophy.

Sign in / Sign up

Export Citation Format

Share Document