Purpose of App Review

  • How well does the ECG analysis app assist clinicians with interpreting electrocardiograms?

Introduction

Electrocardiograms (ECG or EKG) are a commonly used diagnostic test.

An ECG is used to detect abnormal heart rhythms and signs of ischemic disease like a myocardial infarction. Physicians have varying degrees of skill at ECG interpretation, depending on how much clinical experience they have.

ECG Analysis is a free medical app for iPhone and iPad that guides providers through a systematic approach to ECG interpretation.

User Interface

The app contains two guided algorithms: ­ one for a systematic ECG analysis, and another for suspected Acute Coronary Syndrome.

For the systematic ECG analysis, the app guides the user through a series of steps in interpreting an ECG, starting with the rhythm. If the ECG appears to be in sinus rhythm, the user selects Yes to move on, or No if the ECG does not appear to be in sinus.

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If Yes, the user moves onto the next step of interpreting the rate.

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If the rhythm is not sinus, it directs the user to a section on interpreting ectopic rhythms.

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The algorithm continues in this choose-­your-­own-­adventure format until it arrives at a final conclusion, displayed with the patient’s information as input by the user with notes on interpretation on the right.

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The user can also analyze an ECG by taking a photo of the separate leads and matching the morphology up with different examples provided by the app that can be superimposed onto the photo.

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In the Acute Coronary Syndromes section, the app reviews different ischemic patterns that may appear on the ECG.

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This section also covers different treatment options.

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This app seems like a great idea. The graphics are wonderful. The ECG photo input with superimposed examples is a neat tool. It sounds like it could be a useful tool for clinicians that they can use at the bedside to systematically interpret ECGs and identify and treat ACS.

Unfortunately, I don’t think this medical app can accomplish that lofty goal. Clinicians should not be aspiring to input the details of an ECG into a machine and have an automatic answer pop out. Most ECGs already come with automatic interpretations, and we’re supposed to learn to ignore those and use our own professional judgement and clinical skills to arrive at a diagnosis.

Like many others, I developed my own systematic method of interpreting ECGs, initially assisted by pocket cards that helped me remember all the steps. I found it tremendously valuable to see an overview of the entire system at once. I would not use the blind algorithm approach used by this app in my practice, since it only shows learners one potential pathway at a time. The goal should not only be to arrive at the correct answer, but to fully comprehend how to figure it out.

Price

  • Free

Likes

  • Comprehensive overview of ECG interpretation with useful graphics.

Dislikes

  • Blind algorithmic approach
  • Unclear clinical application

Conclusions

  • Though this medical app provides a comprehensive overview of ECG interpretation, it is difficult to navigate and not readily applicable to patient care. This app is not available on the Android platform.

iMedicalApps recommended?

  • No

iTunes Link

Rating: 3.25 / 5 stars

  • User Interface – ­ 2 – ­ Difficult to navigate
  • Multimedia usage  -­ 4 – ­ Interesting approach with inputting ECG images to compare with general morphology of different rhythms
  • Price – ­ 5 -­ Free
  • Real world applicability -­ 2 ­- Not helpful for practical clinical use, may be useful for beginning learners, but is not well structured to optimize teaching.

Requirements: Compatible with iPhone 3GS, iPhone 4, iPhone 4S, iPhone 5, iPod touch (3rd generation), iPod touch (4th generation), iPod touch (5th generation) and iPad. Requires iOS 4.3 or later.
Reviewed: Version 1.0
Device used: iPhone 4S, iOS 6.1

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.