4-electrode ECG (DigitalCardio®) vs Standard 10-electrode ECG: Evaluating Ease of Use and Recording Quality

This study is a randomized, crossover clinical trial designed to compare the efficiency, trace quality, and user satisfaction of a novel 4-electrode tablet-based Electrocardiogram (ECG) system (DigitalCardio / CardioSecur®) against a standard 12-lead (10-electrode) ECG device.

Background and Rationale

An electrocardiogram (ECG) is a fundamental diagnostic tool used to record the electrical activity of the heart. Conventional 12-lead ECGs require placing 10 individual electrodes on a patient's limbs and chest while the patient is lying down. While highly detailed, electrode placement and device setup can be time-consuming in clinical workflows. The DigitalCardio tablet system utilizes a simplified 4-electrode setup designed to streamline data acquisition without compromising diagnostic accuracy.

Study Design and Procedures

After an initial screening process led by the principal investigator, eligible participants receive detailed study information and provide written informed consent. Enrolled participants are then randomly assigned in a 1:1 ratio to one of two sequence groups to control for order effects:

*Group A:Undergoes standard 10-electrode ECG acquisition first, followed immediately by 4-electrode DigitalCardio acquisition.

Group B: Undergoes 4-electrode DigitalCardio acquisition first, followed immediately by standard 10-electrode ECG acquisition.

To maintain consistency, both ECG recordings for a given participant are performed by the same healthcare operator within a minimal time interval.

Key Measurements

• Diagnostic Time:Research staff record the exact time elapsed (in minutes) from the initiation of electrode placement to the successful capture of a complete ECG trace for both devices.
• Trace Quality and Concordance:Printed and anonymized ECG traces are submitted to independent evaluators. Evaluators independently assess trace quality based on standardized criteria, comparing automated measurements (frontal axis, median QRS duration, and QT interval) and counting any missing or erroneous leads.
• Healthcare Professional Satisfaction:Participating healthcare professionals complete a structured questionnaire evaluating user satisfaction and usability of the CardioSecur® device in routine practice.

Inclusion criteria

Hospitalized Cardiology Patients:

• Age minimum 18 years
• Hospitalized for an acute or chronic cardiac condition (e.g., heart failure, acute coronary syndrome, arrhythmia, valvular heart disease, etc.)
• Ability to give informed consent
• Hemodynamic stability permitting the performance of an ECG without clinical risk

Cardiology Outpatients:

• Age minimum of 18 years
• Follow-up for a known cardiac condition or suspected cardiovascular disease
• No contraindications to performing an ECG
• Informed consent obtained

Exclusion criteria

• Minor patient (< 18 years of age)
• Adult subject under legal protection, under temporary guardianship, curatorship, or tutelage
• Patient refusing to participate in the study
• Presence of an implantable cardiac device (e.g., pacemaker, defibrillator) that may interfere with ECG measurements
• Severe skin condition preventing the placement of electrodes
• Physical or cognitive inability to follow the study protocol
• Current pregnancy