Arrhythmias & electrophysiology
Accuracy and variability of cardiologist interpretation of single lead electrocardiograms for atrial fibrillation: The VITAL-AF trial
Authors' conclusion
Cardiologist interpretation of point-of-care handheld 1L ECGs has modest diagnostic sensitivity and specificity with substantial variability for AF classification despite high confidence.
Study context
- Population
- Patients aged ≥65 years in the VITAL-AF trial with point-of-care handheld 1L ECG1L ECG tracings
- Participants
- 200 patients
- Comparison
- Cardiologist interpretation of 1L ECG vs same-day 12L ECG
- Outcome
- Sensitivity, specificity, variability and confidence of cardiologist interpretation for AF
Methodological detailscardiologists blinded to algorithm and 12L ECG interpretation, stratified random sampling
- Cardiologists blinded to algorithm and 12L ECG interpretation
- Stratified random sampling
Performance
As reported in the abstract
Cardiologist interpretation of 1L ECGs for AF (vs same-day 12L ECG)
Average sensitivity for atrial fibrillation (AF)
77.4%
range 50%–90.6%, SD=11.4%
Average specificity
73.0%
range 41.3%–94.6%, SD = 15.4%
Mean variability
30.8%
range 0%–76.2%, SD = 23.2%
Average reviewer confidence (out of 5)
3.6
range 2.5–4.2, SD = 0.6
Further findings
Factors associated with sensitivity, specificity, variability and confidence
- Associated factors included age, BMI and presence of artifact
- Multivariable regression
Original publication
Accuracy and variability of cardiologist interpretation of single lead electrocardiograms for atrial fibrillation: The VITAL-AF trial. Am Heart J. Published 13 July 2023. doi:10.
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