ArticleBMC cardiovascular disorders2026
Position-wise comparison of handheld 6-lead ECG versus the standard 12-lead ECG in patients with arrhythmia: comparative study.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAs 12‑lead electrocardiographs (ECGs) require a clinical infrastructure that limits timely access, portable 6‑lead devices may extend diagnostics to community and remote settings. We evaluated the signal equivalence of a handheld 6‑lead ECG (HATIV
methodsIn this prospective single-center study, simultaneous 10-s 12-lead ECGs and time-aligned 10-s segments from 30-s 6-lead recordings were obtained from arrhythmia patients in both supine and sitting positions. A blinded electrophysiologist performed rhythm classification and ECG measurements. Diagnostic accuracy and numerical agreement of key parameters (PR interval, QRS duration, QT/QTc intervals, and amplitudes) were evaluated.
resultsA total of 229 paired recordings were analyzed after excluding 6 pairs. The overall diagnostic accuracy of the 6‑lead versus 12‑lead was 99.1% in the supine position (n = 113) and 99.1% in the sitting position (n = 116); one atrial flutter was misclassified as atrial fibrillation in each position. Bland-Altman analyses showed small mean differences (12‑lead minus 6‑lead): PR + 12.1/ + 7.4 ms (supine/sitting), QRS - 6.4/ - 6.0 ms, QT - 10.3/ - 5.3 ms, QTc - 11.5/ - 6.4 ms; heart‑rate difference ≈0.03 bpm. The absolute differences were < 20 ms in approximately ~ 70% for PR and ~ 55-62% for QT/QTc. In an exploratory asynchronous pairing (supine 12‑lead vs sitting 6‑lead; n = 103), accuracy decreased to 97.1% and parameter differences widened, consistent with postural/temporal effects.
conclusionsIn patients with arrhythmia, the handheld 6‑lead showed near‑perfect rhythm agreement and small numerical differences versus the 12‑lead under synchronized acquisition in both positions. Asynchronous or posture-mismatched comparisons reduce the agreement, and acquisition conditions should be considered. The 6‑lead may be a practical alternative when the 12‑lead is unavailable in patients with arrhythmia.
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