Evaluating the diagnostic accuracy of reduced lead paediatric electrocardiograms.
Document Type
Article
Publication Date
2-2025
Identifier
DOI: 10.1017/S1047951124036023
Abstract
INTRODUCTION: Alternate electrocardiogram acquisition with fewer leads lacks systematic evaluation in children. This study aims to determine if electrocardiograms with fewer leads maintain diagnostic accuracy in paediatrics.
METHODS: This is a single-centre review of 200 randomly selected standard 12-lead electrocardiograms from our hospital database (2017-2020) for patients aged 2 weeks to 21 years. An overlay technique generated 8-lead (limb + V1/V6) and 6-lead (limb only) variations of the 12-lead tracings, resulting in a total of 600 electrocardiograms, which were then interpreted by two independent paediatric electrophysiologists.
RESULTS: In total, 18% (35/200) of the baseline electrocardiograms were abnormal. Intervals were measured in lead II for all electrocardiograms. Comparing 12-lead to 6- and 8-lead electrocardiograms, there was almost perfect agreement for specific rhythm identification (97.5-100%, κ 0.85-1). The 8-lead showed substantial agreement with 12-lead electrocardiograms when identifying specific electrocardiogram patterns (97.5-100%, κ 0.66-1). A similar degree of agreement was not demonstrated with the 6-lead variant. Utilising the 12-lead electrocardiogram as the gold standard, sensitivity and specificity of the 8- and 6-lead electrocardiogram were > 89% for specific rhythm identification. Specificity for specific pattern recognition was > 99% while sensitivity was < 90% for certain variables for both 6- and 8-lead electrocardiogram, likely due to smaller sample size and fewer abnormal electrocardiograms. There was high percent reader agreement (92.5-100%).
CONCLUSIONS: 8-lead electrocardiograms provide comparable diagnostic accuracy to 12-lead electrocardiograms for children. This information holds potential for future technological advancements in electrocardiogram acquisition tailored specifically for paediatrics. Additional studies are required to further refine conventional electrocardiogram acquisition.
Journal Title
Cardiology in the young
Volume
35
Issue
2
First Page
283
Last Page
288
MeSH Keywords
Humans; Electrocardiography; Child; Infant; Child, Preschool; Adolescent; Female; Male; Infant, Newborn; Retrospective Studies; Young Adult; Reproducibility of Results; Arrhythmias, Cardiac
PubMed ID
39658525
Keywords
Electrocardiogram; electrophysiology; paediatric cardiology; reduced lead electrocardiogram; technological advancements
Recommended Citation
Damera MC, Centanni R, Sherman A, et al. Evaluating the diagnostic accuracy of reduced lead paediatric electrocardiograms. Cardiol Young. 2025;35(2):283-288. doi:10.1017/S1047951124036023
