Reliability of Computer Analysis of Electrocardiograms (ECG) of Nigerians

Abstract

Background: Computer programmes have been introduced to electrocardiography (ECG) with most physicians in Africa depending on computer interpretation of ECG. This study was undertaken to evaluate the reliability of computer interpretation of the 12-Lead ECG in the Black race. Methodology: Using the SCHILLER CARDIOVIT AT 10 with in-built computer analysis programme (CAP), 344 ECG were recorded serially and vetted visually with a view to assessing the reliability of computer interpretation of the 12-Lead ECG.

Results: There was agreement with CAP: 99.4% for heart rate, 97.6% (r=0.95; P<0.001) for the frontal plane QRS Axis, 94.0% for cardiac rhythm, 61.4% for Arrhythmias, 60.0% for Heart Block, 53.2% for left ventricular hypertrophy and 41.7% for myocardial infarction and ischaemia. Errors in CAP arose from non-sensing of intrinsic but low voltage waves, mis-sensing of aberrant waves and artifacts, crosstalk between waves of similar morphology and deficiency in programming resulting in failure to recognise differences that are inherent in Negro ECG.

Conclusion: It is suggested that CAP be encouraged, that manufacturers should revisit their programmes to accommodate the major variants peculiar to the Black and that all computerinterpreted ECG should be vetted before adopting the information for clinical use.