Cardiovascular screening in low-income settings using a novel 4-lead smartphone-based electrocardiograph (D-Heart(R))

N. Maurizi, A. Faragli, J. Imberti, N. Briante, M. Targetti, K. Baldini, A. Sall, A. Cisse, F. G. Berzolari, P. Borrelli, F. Avvantaggiato, S. Perlini, N. Marchionni, F. Cecchi, G. Parigi, I. Olivotto

Research output: Contribution to journalArticle


BACKGROUND: MHealth technologies are revolutionizing cardiovascular medicine. However, a low-cost, user-friendly smartphone-based electrocardiograph is still lacking. D-Heart(R) is a portable device that enables the acquisition of the ECG on multiple leads which streams via Bluetooth to any smartphone. Because of the potential impact of this technology in low-income settings, we determined the accuracy of D-Heart(R) tracings in the stratification of ECG morphological abnormalities, compared with 12-lead ECGs. METHODS: Consecutive African patients referred to the Ziguinchor Regional Hospital (Senegal) were enrolled (n=117; 69 males, age 39+/-11years). D-Heart(R) recordings (3 peripheral leads plus V5) were obtained immediately followed by 12 lead ECGs and were assessed blindly by 2 independent observers. Global burden of ECG abnormalities was defined by a semi-quantitative score based on the sum of 9 criteria, identifying four classes of increasing severity. RESULTS: D-Heart(R) and 12-lead ECG tracings were respectively classified as: normal: 72 (61%) vs 69 (59%); mildly abnormal: 42 (36%) vs 45 (38%); moderately abnormal: 3 (3%) vs 3 (3%). None had markedly abnormal tracings. Cohen's weighted kappa (kw) test demonstrated a concordance of 0,952 (p
Original languageEnglish
Pages (from-to)249-252
Number of pages4
JournalInternational Journal of Cardiology
Publication statusPublished - Jun 1 2017



  • Adult
  • Cardiovascular Diseases/diagnosis/economics/epidemiology
  • Cohort Studies
  • Electrocardiography/economics/instrumentation/methods
  • Female
  • Humans
  • Male
  • Mass Screening/economics/instrumentation/methods
  • Middle Aged
  • Poverty/economics
  • Senegal/epidemiology
  • Smartphone/economics/utilization
  • Telemedicine/economics/instrumentation/methods
  • Low-income settings
  • Portable electrocardiograph
  • Telemedicine
  • mHealth

Cite this

Maurizi, N., Faragli, A., Imberti, J., Briante, N., Targetti, M., Baldini, K., Sall, A., Cisse, A., Berzolari, F. G., Borrelli, P., Avvantaggiato, F., Perlini, S., Marchionni, N., Cecchi, F., Parigi, G., & Olivotto, I. (2017). Cardiovascular screening in low-income settings using a novel 4-lead smartphone-based electrocardiograph (D-Heart(R)). International Journal of Cardiology, 236, 249-252. [pii]