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revealsadancingbear t1_j5ooj3h wrote

Ekgs are incredibly complex. I've been interpreting them for 10 years and am still far from an expert. Hospital based computers make lots of errors interpreting them. Just figuring out "is this a heart attack? " is tricky in many cases.

I wonder how many panicked people will go to the ER needlessly compared to how many have real concerning findings.

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smith7018 t1_j5osffy wrote

The Apple Watch has an ECG whose sole purpose is to detect signs of AFib. I'm guessing since they made the scope so narrow that they don't get a lot of false positives.

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revealsadancingbear t1_j5ot4dh wrote

Yes, to my knowledge, determining "afib" is "not afib" is the only validated use of watch-based ekgs.

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MEMENARDO_DANK_VINCI t1_j5pmhms wrote

It’s about the only thing you could use it for as it only gets the arm leads it can’t even determine axis which it would need to diagnose things

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newbies13 t1_j5sqsx0 wrote

Aren't these totally different technologies? I thought ECG was for detecting arrythmia and is very very clear that it can't detect a heart attack. EKG is what they use to detect heart attacks. Lots of watches and devices have ECG functionality at this point, very few have EKG let alone approval as functioning well enough to be advertised.

At least that's my understanding from a very quick look around at watch health features come in smart watches these days.

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revealsadancingbear t1_j5t40n1 wrote

EKG and ecg are synonymous. One is electrocardiogram, one is electrokardiogram. Depends on how Germanic you're feeling.

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nowthenadir t1_j5oq9kb wrote

I think they’re misusing ekg instead of calling it a single lead monitor, similar to what apple has now. They’re decent enough for measuring rate and something like afib, but that’s about it.

The headline is misleading, I thought the same exact thing as you when I read it. Like, does this machine even know what Scarbossa’s criteria are?

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uiucengineer t1_j5oua4x wrote

An EKG doesn’t have to have 12 leads and doesn’t have to know any criteria. Do you think the first EKGs knew scarbossa’s criteria?

Apple also calls it an EKG.

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nowthenadir t1_j5q2hz6 wrote

Technically you are correct, that fits the definition of an ekg. When someone in the modern medical field uses the term ekg, it is referring to a 12 lead ekg. EKG’s of single leads are simply referred to as rhythm or monitoring strips. Like, if an attending physician asked a resident to bring them a patients ekg, and the resident showed up with a rhythm strip, well let’s just say that that resident would likely be humiliated in front of their colleagues in the very near future. Literally, no doctor in America will refer to a single lead tracing as an ekg.

So there’s the literal definition and the way it’s actually used. I identified with the original comment because I am reading that statement as a physician, not a layperson.

The comment I made about criteria was a joke that would only be funny to a very few people that read it. It was not meant to be taken as a serious comment, but sarcasm doesn’t always translate into text well.

Edit: better grammar

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Airbornequalified t1_j5ub2j4 wrote

Plenty of ekgs are not 12-leads. Paramedics will bring in 3-leads and will still be called an ekg by providers

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nowthenadir t1_j5vjpao wrote

Okay, okay. I admitted I was wrong when I said that they misused the word. What more do you want?

What I should have said is that I was confused and worried when I read the title of the article. Then I read the article and realized what they were referring to was a single lead reading, similar to Apple Watch.

I Don’t know what equipment medics have where you are, but I’ve only had them bring in 12 leads. How do you diagnose a STEMI prehospital with a 3 lead? Nobody in any hospital I’ve ever worked at or in any class in medical school has ever referred to anything other than a 12 lead as an ekg. A rhythm strip is technically an ekg, but nobody calls it that. That was the source of my initial confusion.

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uiucengineer t1_j5q5968 wrote

Language is alive and new products and techniques lead to changes. I don’t see this causing any confusion. Your example proves my point—the reason the resident would be humiliated is because it’s obvious from context that you were expecting a 12-lead.

Who is being misled? Who both understands a proper EKG is 12 leads but doesn’t also immediately realize this would be impossible with a watch?

What does “monitoring strip” mean in the context of a wrist watch? That would be very confusing.

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nowthenadir t1_j5q7tzo wrote

I mean, you’re right. I said you’re right. What do you want, a medal? I was simply explaining to you why I interpreted the headline the way I did.

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uiucengineer t1_j5q8zh1 wrote

Dude I wasn’t trying to disparage you, but I think it’s pretty clear you were trying to argue I was “technically” right but wrong in some other more important way. You even threw in that you’re a doctor lol so am I

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nowthenadir t1_j5qa87o wrote

No, you’re right. Just wasn’t sure you’re in medicine, so was explaining why I read that the way I did.

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mashuto t1_j5pkjy3 wrote

They do very specifically give the users a warning that it cannot detect heart attacks, it cannot detect strokes, it basically can only tell you if it thinks its a normal sinus rythm or potentially afib. Pretty sure thats about par for the course for other watches with similar features as well.

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MEMENARDO_DANK_VINCI t1_j5pn25j wrote

If you can already interrupt ekgs you can get some other data from them, not very actionable but I had the presence of mind to activate the watch while I blacked out due to a vagal, got half a cool recording before I moved too much for it, but I was vaguely reassured

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Weird_Cantaloupe2757 t1_j5p1zoh wrote

I’m not terribly worried about false positives with a device like this, unless it happens repeatedly to the same person — there are a whole lot of undiagnosed, asymptomatic heart conditions out there, so even if it gets them to the cardiologist on a “false alarm”, I would imagine that some nontrivial percent of those people could find something that they didn’t know to look for by getting their heart checked out.

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Hysterical__Paroxysm t1_j5vml8w wrote

>unless it happens repeatedly to the same person

This is what made my team and I take it seriously. I was also able to export the date to my GP easily. I was in the cardiologist's office the next day.

Of course I was allergic to the Zio lol. Next step is implanting a monitoring device. Really interesting and fascinating.

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aysurcouf t1_j5su49e wrote

Or how many people it could make not go to the ER, I went to the ER because I was having crazy heart palpitations I looked it up and started checking almost every symptom off the list of having a heart attack as it became more severe. I woke my wife up to drive me to the hospital, turned out I was fine, I was having a severe anxiety attack. Maybe something on my wrist that could help assure me that I’m okay might be a good thing, I think if I had one of these and saw that all was okay I wouldn’t have freaked out in the first place which mad me more and more panicked, mocking the symptoms more and more.

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Hysterical__Paroxysm t1_j5vli4d wrote

I made an appointment with my GP because I kept getting alerts. I wasn't dead yet, so I could wait a week, you know?

They had me at a cardiologist the next day. I apparently have some undiagnosed genetic heart condition. I had other symptoms as well, but the watch was annoying so I finally went in.

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Thanhansi-thankamato t1_j5wvcsf wrote

I actually worked on a device like this. Suffice to say the hospital machines are extremely bare bones tech that hasn’t been updated since it’s creation.

These new ones are extremely advanced. I signed an NDA so I have to be a bit vague.

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