Assessing the Feasibility and Accuracy of Wearable 12-Lead ECG in The  Diagnosis of Acute Coronary Syndromes

Study design: This is a prospective single centre observational study done in a tertiary care centre. Conventional 12 lead ECGs (C-ECG) and 12 lead ECGs using wearable vests (V-ECG) were recorded in&nbsp; hemodynamically stable adult patients admitted with ACS in the cardiac care unit and patients with normal ECG from the outpatient department.Sensitivity and specificity of V- ECG in the diagnosis of Acute coronary syndrome (ACS) was assessed compared to C-ECG.<br><br>Methods: In this prospective, single centre observational study, a wearable vest with embedded electrodes was used for 12 lead ECG acquisition (V-ECG) in patients with ACS and patients with normal ECG. Location of the electrodes in the vest was in line with the previous data, wherein 10 specific torso positions (near both shoulders, 2 finger breadth away from umbilicus in 12 o’clock and 3 o’clock and conventional 6 precordial positions) were shown to generate 12 lead ECGs comparable to conventional ECG (C-ECG) for the diagnosis of ACS. Three sizes of vest were used depending on the body surface area. All the ECGs were interpreted by blinded observers. Sensitivity and specificity of V-ECG for the diagnosis of ACS was determined vis-a-vis&nbsp; C-ECG ,the gold standard.<br><br>Results: Out of a total of 133 patients, in 5 patients (3 males and 2 females) in whom the vest could not be applied properly were excluded. Out of the remaining 128 patients (69 % Males, 31% females; mean age 56.2 years), 72 had ACS. Conventional 12 lead ECGs (C-ECG) and Vest based 12 lead ECGs (V-ECG) were recorded in all patients. 4 patients had an additional set of ECGs recorded in view of dynamic ECG changes during hospitalisation. V-ECG had a 97.2% sensitivity and 96.7% specificity for the diagnosis of ACS vis-a-vis C-ECG. This high sensitivity and specificity was retained for STEMI and NSTEMI and also based location of ECG changes on the C-ECG (anterior, inferior and lateral).&nbsp;<br><br>Conclusions: 12 lead ECG recording by a wearable garment using novel torso positions is feasible in vast majority including both genders and fairly accurate for the diagnosis of ACS. Commercial availability of this vest might enable an otherwise lay person, to record an ECG in out-of-hospital setting (even at home), thus leading to an expedited diagnosis of ACS, and saving precious time and lives.<br><br>Funding Information: None.<br><br>Declaration of Interests: The authors declare no conflicts of interest.<br><br>Ethics Approval Statement: This was a prospective single centre observational study done in a tertiary care centre and was approved by the Institutional Ethics Committee (Proposal number IEC-22-056)