Abstract：
BACKGROUND: In patients with congenital long QT syndrome (LQTS), the risk of ventricular arrhythmia is correlated with the duration of the corrected QT interval and the changes in the ST-T wave pattern on the 12-lead surface electrocardiogram (12L-ECG). Remote monitoring of these variables could be useful.
OBJECTIVE: To evaluate the abilities of two wearable electrocardiogram devices (Apple Watch and KardiaMobile 6L) to provide reliable electrocardiograms in terms of corrected QT interval and ST-T wave patterns in patients with LQTS.
METHODS: In a prospective multicentre study (ClinicalTrials.gov identifier: NCT04728100), a 12L-ECG, a 6-lead KardiaMobile 6L electrocardiogram and two single-lead Apple Watch electrocardiograms were recorded in patients with LQTS. The corrected QT interval and ST-T wave patterns were evaluated manually.
RESULTS: Overall, 98 patients with LQTS were included; 12.2% were children and 92.8% had a pathogenic variant in an LQTS gene. The main genotypes were LQTS type 1 (40.8%), LQTS type 2 (36.7%) and LQTS type 3 (7.1%); rarer genotypes were also represented. When comparing the ST-T wave patterns obtained with the 12L-ECG, the level of agreement was moderate with the Apple Watch (k=0.593) and substantial with the KardiaMobile 6L (k=0.651). Regarding the corrected QT interval, the correlation with 12L-ECG was strong for the Apple Watch (r=0.703 in lead II) and moderate for the KardiaMobile 6L (r=0.593). There was a slight overestimation of corrected QT interval with the Apple Watch and a subtle underestimation with the KardiaMobile 6L.
CONCLUSIONS: In patients with LQTS, the corrected QT interval and ST-T wave patterns obtained with the Apple Watch and the KardiaMobile 6L correlated with the 12L-ECG. Although wearable electrocardiogram devices cannot replace the 12L-ECG for the follow-up of these patients, they could be interesting additional monitoring tools.
OBJECTIVE: To evaluate the abilities of two wearable electrocardiogram devices (Apple Watch and KardiaMobile 6L) to provide reliable electrocardiograms in terms of corrected QT interval and ST-T wave patterns in patients with LQTS.
METHODS: In a prospective multicentre study (ClinicalTrials.gov identifier: NCT04728100), a 12L-ECG, a 6-lead KardiaMobile 6L electrocardiogram and two single-lead Apple Watch electrocardiograms were recorded in patients with LQTS. The corrected QT interval and ST-T wave patterns were evaluated manually.
RESULTS: Overall, 98 patients with LQTS were included; 12.2% were children and 92.8% had a pathogenic variant in an LQTS gene. The main genotypes were LQTS type 1 (40.8%), LQTS type 2 (36.7%) and LQTS type 3 (7.1%); rarer genotypes were also represented. When comparing the ST-T wave patterns obtained with the 12L-ECG, the level of agreement was moderate with the Apple Watch (k=0.593) and substantial with the KardiaMobile 6L (k=0.651). Regarding the corrected QT interval, the correlation with 12L-ECG was strong for the Apple Watch (r=0.703 in lead II) and moderate for the KardiaMobile 6L (r=0.593). There was a slight overestimation of corrected QT interval with the Apple Watch and a subtle underestimation with the KardiaMobile 6L.
CONCLUSIONS: In patients with LQTS, the corrected QT interval and ST-T wave patterns obtained with the Apple Watch and the KardiaMobile 6L correlated with the 12L-ECG. Although wearable electrocardiogram devices cannot replace the 12L-ECG for the follow-up of these patients, they could be interesting additional monitoring tools.
摘要：
背景：先天性长QT综合征（LQTS）患者，室性心律失常的风险与校正QT间期的持续时间以及12导联体表心电图(12L-ECG)上ST-T波型的变化相关.远程监测这些变量可能是有用的。
目的：评估两种可穿戴心电图设备（AppleWatch和KardiaMobile6L）在LQTS患者的校正QT间期和ST-T波型方面提供可靠心电图的能力。
方法：在一项前瞻性多中心研究中（ClinicalTrials.gov标识符：NCT04728100），12L-心电图,记录了LQTS患者的6导联KardiaMobile6L心电图和2个单导联AppleWatch心电图.手动评估校正后的QT间期和ST-T波型。
结果：总体而言，包括98例LQTS患者；12.2％为儿童，92.8％具有LQTS基因的致病性变异。主要基因型为LQTS1型(40.8%),LQTS2型（36.7％）和LQTS3型（7.1％）；也代表了罕见的基因型。当将获得的ST-T波模式与12L-ECG进行比较时，与AppleWatch（k=0.593）的协议水平适中，与KardiaMobile6L（k=0.651）的协议水平相当。关于校正后的QT间隔，AppleWatch与12L-ECG的相关性较强(II导联r=0.703),KardiaMobile6L的相关性中等(r=0.593).AppleWatch对校正后的QT间隔略有高估，而KardiaMobile6L则略有低估。
结论：在LQTS患者中，使用AppleWatch和KardiaMobile6L获得的校正QT间期和ST-T波型与12L-ECG相关。虽然穿戴式心电图设备不能代替12L-ECG对这些患者进行随访,它们可能是有趣的额外监控工具。
目的：评估两种可穿戴心电图设备（AppleWatch和KardiaMobile6L）在LQTS患者的校正QT间期和ST-T波型方面提供可靠心电图的能力。
方法：在一项前瞻性多中心研究中（ClinicalTrials.gov标识符：NCT04728100），12L-心电图,记录了LQTS患者的6导联KardiaMobile6L心电图和2个单导联AppleWatch心电图.手动评估校正后的QT间期和ST-T波型。
结果：总体而言，包括98例LQTS患者；12.2％为儿童，92.8％具有LQTS基因的致病性变异。主要基因型为LQTS1型(40.8%),LQTS2型（36.7％）和LQTS3型（7.1％）；也代表了罕见的基因型。当将获得的ST-T波模式与12L-ECG进行比较时，与AppleWatch（k=0.593）的协议水平适中，与KardiaMobile6L（k=0.651）的协议水平相当。关于校正后的QT间隔，AppleWatch与12L-ECG的相关性较强(II导联r=0.703),KardiaMobile6L的相关性中等(r=0.593).AppleWatch对校正后的QT间隔略有高估，而KardiaMobile6L则略有低估。
结论：在LQTS患者中，使用AppleWatch和KardiaMobile6L获得的校正QT间期和ST-T波型与12L-ECG相关。虽然穿戴式心电图设备不能代替12L-ECG对这些患者进行随访,它们可能是有趣的额外监控工具。
