Feasibility and accuracy of using mobile phone images of electrocardiograms to initiate the cardiac catheterization process

Abstract

We assessed the feasibility of interpreting the presence of ST-segment elevation myocardial infarction (STEMI) using ECGs captured and transmitted by mobile phones. Transmitted ECGs were interpreted by four independent and blinded physicians, who classified them as STEMI, non-STEMI or indeterminate. After 2-4 weeks the same physicians were given the original paper ECGs for interpretation. In total, 87 ECGs were randomly selected for review. The overall agreement between the digital image readings and the printed copy readings was 94%. Of the 87 patients, 65 (75%) had cardiac catheterization following a STEMI ECG and 22 (25%) did not receive cardiac catheterization. The accuracy of digital ECGs and printed ECGs when compared to the findings from cardiac catheterization was similar. Agreement in ECG interpretations between printed images and mobile phone images was excellent, and both had similar accuracy in activating the cardiac catheterization laboratory. Mobile phone transmission is an inexpensive method of evaluating ECG images sent from pre-hospital settings to the emergency department.