Reliability of remote ECG mobile real-time monitoring system

doi:10.3877/cma.j.issn.2095-9133.2017.02.007

Abstract

Abstract:

Objective

To evaluate the accuracy and reliability of ECG remote mobile monitoring system in remote dynamic monitoring, early warning of abnormal electrical activity and long-range records.

Methods

A prospective study was conducted on 60 cases patients needing electrocardiogram (ECG) or dynamic ECG examination continuously selected from Qilu Hospital of Shandong University from October to December 2014. All patients were examined with ECG RHMS and dynamic ECG monitor simultaneously for 24 hours. The stability of ECG RHMS dynamically sending ECG records was evaluated by collecting the baseline drift, maximum and average value of ECG and compared with the ordinary static 12-lead electrocardiogram. The waveform amplitude and duration of leads (Ⅰ, Ⅱ, Ⅲ, aVR, aVL, aVF, V1, V5) in ECG detection results of various recording methods were recorded in the same patient and at the same time. The image quality was evaluated by comparing ECG RHMS with ordinary static 12-lead electrocardiogram and dynamic electrocardiogram. The abnormal electrical activity in real-time ECG fragments automatically sent by ECG RHMS remote mobile monitoring system was counted and classified to compare with dynamic electrocardiogram of the same patient and at the same time. The long range (22 h or higher) of ECG RHMS was recorded and classified to compare with the dynamic electrocardiogram of the same patient.

Results

There were 34 males and 26 females, aged 16-96 years, average (58±14.5)years. According to ECG RHMS monitoring system, the limit of the electrocardiogram drift rate was for 5.0% (3/60), the average deviation for (0.10±0.64) mm and the maximum displacement for 2 mm, with no statistically significant difference compared with dynamic electrocardiogram (P>0.05). The reliability of remote mobile ECG RHMS monitoring system for real-time sending segments of ECG graphics was 97.75% (2 820/2 885), with no statistical significance in comparison with ordinary static 12-lead electrocardiogram (P>0.05). The wave amplitudes, time limits and degrees of ST segment deviation differences collected by remote mobile ECG RHMS monitoring system showed no statistical difference compared with the same patient, the same time points and same lead dynamic electrocardiogram (P>0.05). The records of all kinds of abnormal electrical activity in segments of electrocardiogram and long-range electrocardiogram sent by the remote mobile ECG RHMS monitoring system had no differences in comparison with the dynamic electrocardiograms of same patient at the same time (P>0.05).

Conclusion

Remote mobile RHMS ECG monitoring system can be more sensitive to find abnormal ECG activity and warn in time to accurately and quickly sending records and hence provide effective security in real-time monitoring, early prevention and early intervention for high-risk persons with abnormal electrical activity, as is beneficial to reduce harm of arrhythmia to patients and is worthy of extensive application in clinical work.

Key words: Electrocardiogram, Dynamic electrocardiogram, Real time, Mobile network, GPRS, Remote monitoring, Arrhythmia

Baotian Kan, Tianzi Jian, Ming Lv, Yongliang Yi, Xiangdong Jian, Haiqing Gao. Reliability of remote ECG mobile real-time monitoring system[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2017, 03(02): 98-103.

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Figures/Tables 5

References 11

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组别	例数	P波
组别	例数	Ⅰ	Ⅱ	Ⅲ	aVR	aVL	aVF	V₁	V₅
RHMS组	60	0.28±0.01	0.35±0.04	0.30±0.02	0.27±0.02	0.27±0.01	0.32±0.03	0.29±0.04	0.30±0.07
动态心电图	60	0.29±0.02	0.34±0.01	0.32±0.03	0.30±0.05	0.29±0.04	0.31±0.01	0.28±0.03	0.31±0.02
P值	?	0.32	0.27	0.45	0.10	0.36	0.54	0.38	0.67
组别	例数	QRS主波
组别	例数	Ⅰ	Ⅱ	Ⅲ	aVR	aVL	aVF	V₁	V₅
RHMS组	60	0.92±0.12	1.41±0.11	1.35±0.12	1.15±0.08	0.83±0.13	1.23±0.09	1.62±0.15	1.75±0.14
动态心电图	60	0.93±0.10	1.44±0.12	1.42±0.15	1.24±0.14	0.82±0.15	1.16±0.12	1.65±0.11	1.72±0.12
P值	?	0.21	0.45	0.34	0.56	0.49	0.15	0.69	0.33
组别	例数	]T波
组别	例数	Ⅰ	Ⅱ	Ⅲ	aVR	aVL	aVF	V₁	V₅
RHMS组	60	0.23±0.02	0.33±0.03	0.32±0.04	0.30±0.01	0.25±0.04	0.29±0.03	0.31±0.04	0.32±0.05
动态心电图	60	0.25±0.01	0.35±0.02	0.33±0.04	0.32±0.05	0.26±0.03	0.30±0.01	0.29±0.03	0.31±0.02
P值	?	0.16	0.31	0.11	0.78	0.35	0.29	0.19	0.57

组别	例数	P波
组别	例数	Ⅰ	Ⅱ	Ⅲ	aVR	aVL	aVF	V₁	V₅
RHMS组	60	0.28±0.01	0.35±0.04	0.30±0.02	0.27±0.02	0.27±0.01	0.32±0.03	0.29±0.04	0.30±0.07
动态心电图	60	0.29±0.02	0.34±0.01	0.32±0.03	0.30±0.05	0.29±0.04	0.31±0.01	0.28±0.03	0.31±0.02
P值	?	0.32	0.27	0.45	0.10	0.36	0.54	0.38	0.67
组别	例数	QRS主波
组别	例数	Ⅰ	Ⅱ	Ⅲ	aVR	aVL	aVF	V₁	V₅
RHMS组	60	0.92±0.12	1.41±0.11	1.35±0.12	1.15±0.08	0.83±0.13	1.23±0.09	1.62±0.15	1.75±0.14
动态心电图	60	0.93±0.10	1.44±0.12	1.42±0.15	1.24±0.14	0.82±0.15	1.16±0.12	1.65±0.11	1.72±0.12
P值	?	0.21	0.45	0.34	0.56	0.49	0.15	0.69	0.33
组别	例数	]T波
组别	例数	Ⅰ	Ⅱ	Ⅲ	aVR	aVL	aVF	V₁	V₅
RHMS组	60	0.23±0.02	0.33±0.03	0.32±0.04	0.30±0.01	0.25±0.04	0.29±0.03	0.31±0.04	0.32±0.05
动态心电图	60	0.25±0.01	0.35±0.02	0.33±0.04	0.32±0.05	0.26±0.03	0.30±0.01	0.29±0.03	0.31±0.02
P值	?	0.16	0.31	0.11	0.78	0.35	0.29	0.19	0.57

组别	例数	P波时限	QRS波时限	T波时限	P-R间期	Q-T间期
RHMS组	60	0.09±0.02	0.09±0.02	0.13±0.03	0.17±0.03	0.36±0.04
动态心电图组	60	0.10±0.01	0.09±0.03	0.13±0.02	0.16±0.01	0.37±0.02
P值	?	0.57	0.37	0.58	0.09	0.52

组别	例数	P波时限	QRS波时限	T波时限	P-R间期	Q-T间期
RHMS组	60	0.09±0.02	0.09±0.02	0.13±0.03	0.17±0.03	0.36±0.04
动态心电图组	60	0.10±0.01	0.09±0.03	0.13±0.02	0.16±0.01	0.37±0.02
P值	?	0.57	0.37	0.58	0.09	0.52

组别	例数	Ⅱ	Ⅲ	aVF	V₁	V₅
RHMS组	60	0.01±0.01	0.01±0.02	0.01±0.01	0.20±0.03	0.02±0.01
动态心电图组	60	0.02±0.02	0.03±0.02	0.02±0.01	0.18±0.04	0.02±0.02
P值	?	0.13	0.21	0.59	0.08	0.34

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