{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T04:54:21Z","timestamp":1771822461066,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T00:00:00Z","timestamp":1677283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Agency (ANR)","award":["ANR-10-IAHU-04"],"award-info":[{"award-number":["ANR-10-IAHU-04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Smartwatches that support the recording of a single-lead electrocardiogram (ECG) are increasingly being used beyond the wrist, by placement on the ankle and on the chest. However, the reliability of frontal and precordial ECGs other than lead I is unknown. This clinical validation study assessed the reliability of an Apple Watch (AW) to obtain conventional frontal and precordial leads as compared to standard 12-lead ECGs in both subjects without known cardiac anomalies and patients with underlying heart disease. In 200 subjects (67% with ECG anomalies), a standard 12-lead ECG was performed, followed by AW recordings of the standard Einthoven leads (leads I, II, and III) and precordial leads V1, V3, and V6. Seven parameters (P, QRS, ST, and T-wave amplitudes, PR, QRS, and QT intervals) were compared through a Bland\u2013Altman analysis, including the bias, absolute offset, and 95% limits of agreement. AW-ECGs recorded on the wrist but also beyond the wrist had similar durations and amplitudes compared to standard 12-lead ECGs. Significantly greater amplitudes were measured by the AW for R-waves in precordial leads V1, V3, and V6 (+0.094 mV, +0.149 mV, +0.129 mV, respectively, all p &lt; 0.001), indicating a positive bias for the AW. AW can be used to record frontal, and precordial ECG leads, paving the way for broader clinical applications.<\/jats:p>","DOI":"10.3390\/s23052555","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T02:10:46Z","timestamp":1677463846000},"page":"2555","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Using a Smartwatch to Record Precordial Electrocardiograms: A Validation Study"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4998-6363","authenticated-orcid":false,"given":"Joske","family":"van der Zande","sequence":"first","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-33600 Pessac, France"},{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"},{"name":"Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands"}]},{"given":"Marc","family":"Strik","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-33600 Pessac, France"},{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3320-6086","authenticated-orcid":false,"given":"R\u00e9mi","family":"Dubois","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-33600 Pessac, France"},{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"}]},{"given":"Sylvain","family":"Ploux","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-33600 Pessac, France"},{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6638-4233","authenticated-orcid":false,"given":"Saer Abu","family":"Alrub","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"},{"name":"Cardiology Department, Clermont Universite, Universit\u00e9 d\u2019Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France"}]},{"given":"Th\u00e9o","family":"Caillol","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-33600 Pessac, France"},{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"}]},{"given":"Mathieu","family":"Nasarre","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6496-2768","authenticated-orcid":false,"given":"Dirk W.","family":"Donker","sequence":"additional","affiliation":[{"name":"Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0150-306X","authenticated-orcid":false,"given":"Eline","family":"Oppersma","sequence":"additional","affiliation":[{"name":"Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands"}]},{"given":"Pierre","family":"Bordachar","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-33600 Pessac, France"},{"name":"Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1016\/j.hrthm.2021.06.1176","article-title":"Smartwatch-Based Detection of Cardiac Arrhythmias: Beyond the Differentiation between Sinus Rhythm and Atrial Fibrillation","volume":"18","author":"Strik","year":"2021","journal-title":"Heart Rhythm"},{"key":"ref_2","first-page":"1106","article-title":"Current Perspectives on Wearable Rhythm Recordings for Clinical Decision-Making: The WEHRAbles 2 Survey","volume":"23","author":"Manninger","year":"2021","journal-title":"EP Eur."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.tcm.2019.10.010","article-title":"How Useful Is the Smartwatch ECG?","volume":"30","author":"Isakadze","year":"2020","journal-title":"Trends Cardiovasc. 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