Comparison of AliveCor KardiaMobile Six-Lead ECG with Standard ECG in Pediatric Patients

The AliveCor KardiaMobile (ACKM) is a remote electrocardiogram (ECG) monitoring device. Little research has been conducted on its accuracy with pediatric patients. This prospective study aims to compare the ACKM six-lead device with a standard fifteen-lead ECG in measuring the QTc, QRS, and axis in pediatric patients. Pediatric patients ages 5 to 21 years were enrolled prospectively to have their ECG recorded using an ACKM six-lead device following a recording with the standard 15-lead ECG. A pediatric electrophysiologist measured the QTc, QRS interval, and QRS axis for both ECGs. Bland–Altman analysis was performed to assess agreement among measurements. The study included 141 patients. The mean age was 12.3 ± 4.4 years. Average heart rate was 79 ± 16 bpm. The mean difference in the QTc measurements for a paired standard ECG and ACKM was − 0.6 ms [95% confidence interval − 48 to 47 ms]. Of the ACKM QTc measurements, 117 (83%) were within 30 ms of the standard ECG. The mean difference in paired QRS measurements was − 1.3 ms [95% confidence interval − 23 to 21 ms]. Of the ACKM QRS measurements, 134 (95%) were within 20 ms of the standard ECG. The measured axis was the same for 84% of ACKM and standard ECGs. Over 80% of the ACKM six-lead ECGs produced QTc, QRS, and axis deviation measurements within a clinically useful range of the standard ECG. However, it is not accurate enough to be used consistently in place of a standard ECG for QTc and QRS measurement for pediatric patients.