Performance of a body surface mapping system using emergency physician real-time interpretation

Objective

We compared the performance characteristics of the 12-lead electrocardiography (ECG) with body surface mapping (BSM) in patients presenting for evaluation of symptoms suggestive of acute coronary syndromes.

Methods

The diagnostic test characteristics (sensitivity, specificity, likelihood ratios, and predictive values) for 12-lead ECG and BSM were computed using 3 different criterion standards.

Results

Of the 150 patients enrolled, 19 were positive for acute coronary syndromes using the criterion standard of cardiac troponin T >0.1 ng/mL, percutaneous coronary intervention, more than 70% stenosis, abnormal noninvasive testing, and coronary artery bypass graft. Changes not known to be old on ECG and BSM had sensitivities of 10.5 (95% confidence interval CI₉₅], 1.8-34.5) and 15.8 (CI₉₅, 4.2-40.5), and specificities of 90.1 (CI₉₅, 83.3-94.4) and 86.3 (CI₉₅, 78.9-91.4), respectively.

Conclusion

In this emergency department population, both the BSM and the 12-lead ECG exhibited similar test characteristics.