{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:41:50Z","timestamp":1771548110793,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Innovation Fund Denmark"},{"name":"Novo Nordic Foundation"},{"name":"Danish Cancer Society"},{"name":"Steno Diabetes Center Denmark"},{"name":"Copenhagen Center for Health Technology"},{"name":"Radiometer, A.P. M\u00f8ller Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Wearable wireless electrocardiographic (ECG) monitoring is well-proven for arrythmia detection, but ischemia detection accuracy is not well-described. We aimed to assess the agreement of ST-segment deviation from single- versus 12-lead ECG and their accuracy for the detection of reversible ischemia. Bias and limits of agreement (LoA) were calculated between maximum deviations in ST segments from single- and 12-lead ECG during 82Rb PET-myocardial cardiac stress scintigraphy. Sensitivity and specificity for reversible anterior-lateral myocardial ischemia detection were assessed for both ECG methods, using perfusion imaging results as a reference. Out of 110 patients included, 93 were analyzed. The maximum difference between single- and 12-lead ECG was seen in II (\u22120.019 mV). The widest LoA was seen in V5, with an upper LoA of 0.145 mV (0.118 to 0.172) and a lower LoA of \u22120.155 mV (\u22120.182 to \u22120.128). Ischemia was seen in 24 patients. Single-lead and 12-lead ECG both had poor accuracy for the detection of reversible anterolateral ischemia during the test: single-lead ECG had a sensitivity of 8.3% (1.0\u201327.0%) and specificity of 89.9% (80.2\u201395.8%), and 12-lead ECG a sensitivity of 12.5% (3.0\u201334.4%) and a specificity of 91.3% (82.0\u201396.7%). In conclusion, agreement was within predefined acceptable criteria for ST deviations, and both methods had high specificity but poor sensitivity for the detection of anterolateral reversible ischemia. Additional studies must confirm these results and their clinical relevance, especially in the light of the poor sensitivity for detecting reversible anterolateral cardiac ischemia.<\/jats:p>","DOI":"10.3390\/s23062962","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T02:01:47Z","timestamp":1678327307000},"page":"2962","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Wireless Single-Lead versus Standard 12-Lead ECG, for ST-Segment Deviation during Adenosine Cardiac Stress Scintigraphy"],"prefix":"10.3390","volume":"23","author":[{"given":"Luna","family":"Fabricius Ekenberg","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan Eik","family":"H\u00f8fsten","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet Copenhagen University Hospital, 2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-2871","authenticated-orcid":false,"given":"S\u00f8ren M.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Biomedical Signal Processing & AI Research Group, Digital Health Section, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2062-9570","authenticated-orcid":false,"given":"Jesper","family":"M\u00f8lgaard","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Hasbak","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiological and Nuclear Medicine, Center for Diagnostics, Rigshospitalet Copenhagen University Hospital, 2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helge B. D.","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Biomedical Signal Processing & AI Research Group, Digital Health Section, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-4609","authenticated-orcid":false,"given":"Christian S.","family":"Meyhoff","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7131-2461","authenticated-orcid":false,"given":"Eske K.","family":"Aasvang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9, 2200 Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"International Surgical Outcomes Study Group TISOS (2016). Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries. Br. J. Anaesth., 117, 601\u2013609.","DOI":"10.1093\/bja\/aew316"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/j.surg.2015.11.007","article-title":"Surgical outcomes in patients with chronic obstructive pulmonary disease undergoing abdominal operations: An analysis of 331,425 patients","volume":"159","author":"Fields","year":"2016","journal-title":"Surgery"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S0140-6736(12)61266-5","article-title":"Acute pneumonia and the cardiovascular system","volume":"381","author":"Musher","year":"2013","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.pcad.2020.05.013","article-title":"Special Article\u2014Acute myocardial injury in patients hospitalized with COVID-19 infection: A review","volume":"63","author":"Bavishi","year":"2020","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"523","DOI":"10.7326\/0003-4819-154-8-201104190-00003","article-title":"Characteristics and Short-Term Prognosis of Perioperative Myocardial Infarction in Patients Undergoing Noncardiac Surgery: A Cohort Study","volume":"154","author":"Devereaux","year":"2011","journal-title":"Ann. Intern. Med."},{"key":"ref_6","unstructured":"Writing Committee for the VISION Study Investigators, Devereaux, P.J., Biccard, B.M., Sigamani, A., Xavier, D., Chan, M.T.V., Srinathan, S.K., Walsh, M., Abraham, V., and Pearse, R. (2017). Association of Postoperative High-Sensitivity Troponin Levels With Myocardial Injury and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. JAMA, 317, 1642\u20131651."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1097\/ALN.0000000000000113","article-title":"Myocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes","volume":"120","author":"Botto","year":"2014","journal-title":"Anesthesiology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/ALN.0b013e31828866b3","article-title":"Pain Intensity on the First Day after Surgery: A Prospective Cohort Study Comparing 179 Surgical Procedures","volume":"118","author":"Gerbershagen","year":"2013","journal-title":"Anesthesiology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1056\/NEJM198411013111802","article-title":"Incidence and Prognosis of Unrecognized Myocardial Infarction","volume":"311","author":"Kannel","year":"1984","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2017.10.071","article-title":"Silent Myocardial Infarction and Long-Term Risk of Heart Failure in the Atherosclerosis Risk in Communities (ARIC) Study","volume":"71","author":"Qureshi","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1001\/archinte.1989.00390070068008","article-title":"The incidence and prognosis of unrecognized myocardial infarction in the Honolulu, Hawaii, Heart Program","volume":"149","author":"Yano","year":"1989","journal-title":"Arch. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.1111\/anae.14860","article-title":"Enhanced postoperative recovery: Good from afar, but far from good?","volume":"75","author":"Kehlet","year":"2020","journal-title":"Anaesthesia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2260","DOI":"10.1093\/eurheartj\/ehu038","article-title":"2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology","volume":"35","author":"Montalescot","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zhu, H., Pan, Y., Wu, F., and Huan, R. (2019). Optimized Electrode Locations for Wearable Single-Lead ECG Monitoring Devices: A Case Study Using WFEES Modules Based on the LANS Method. Sensors, 19.","DOI":"10.3390\/s19204458"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3414\/ME16-01-0067","article-title":"Reconstruction of 12-lead ECG Using a Single-patch Device","volume":"56","author":"Lee","year":"2017","journal-title":"Methods Inf. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s13239-022-00617-3","article-title":"ECG Signal Quality Assessments of a Small Bipolar Single-Lead Wearable Patch Sensor","volume":"13","author":"Rajbhandary","year":"2022","journal-title":"Cardiovasc. Eng. Technol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Jennings, M., Guldenring, D., Bond, R., Rababah, A., McLaughlin, J., and Finlay, D. (2019). ST Changes Observed in Short Spaced Bipolar Leads Suitable for Patch Based Monitoring, Biopolis.","DOI":"10.22489\/CinC.2019.096"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijcard.2021.11.039","article-title":"Evolution of single-lead ECG for STEMI detection using a deep learning approach","volume":"346","author":"Gibson","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"105002","DOI":"10.1088\/1361-6579\/ac92be","article-title":"Comparison of single-lead and multi-lead ECG for QT variability assessment using autoregressive modelling","volume":"43","author":"Baumert","year":"2022","journal-title":"Physiol. Meas."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1161\/CIR.0000000000000527","article-title":"Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association","volume":"136","author":"Sandau","year":"2017","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1016\/j.jacc.2012.07.038","article-title":"Does Rubidium-82 PET Have Superior Accuracy to SPECT Perfusion Imaging for the Diagnosis of Obstructive Coronary Disease?: A systematic review and meta-analysis","volume":"60","author":"Dowsley","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2040622319884819","DOI":"10.1177\/2040622319884819","article-title":"Current approach to the diagnosis of atherosclerotic coronary artery disease: More questions than answers","volume":"10","author":"Nelson","year":"2019","journal-title":"Ther. Adv. Chronic Dis."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Duncker, D., Ding, W.Y., Etheridge, S., Noseworthy, P.A., Veltmann, C., Yao, X., Bunch, T., and Gupta, D. (2021). Smart Wearables for Cardiac Monitoring\u2014Real-World Use beyond Atrial Fibrillation. Sensors, 21.","DOI":"10.3390\/s21072539"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1111\/aas.14056","article-title":"Continuously monitored vital signs for detection of myocardial injury in high-risk patients\u2014An observational study","volume":"66","author":"Loft","year":"2022","journal-title":"Acta Anaesthesiol. Scand."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/6\/2962\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:51:32Z","timestamp":1760122292000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/6\/2962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,9]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["s23062962"],"URL":"https:\/\/doi.org\/10.3390\/s23062962","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,9]]}}}