Ambulatory ECG monitoring during myocardial ischaemia
Research type
Research Study
Full title
Assessing the utility of ambulatory ECG monitoring devices in detecting myocardial ischaemia
IRAS ID
317244
Contact name
Divaka Perera
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
0 years, 6 months, 2 days
Research summary
Under normal circumstances, the blood supply to the heart muscle is commensurate with demand. However, under certain circumstances, this supply is not enough to meet the demand; this is known as myocardial ischaemia and manifests as angina, which is a specific type of chest pain. The gold standard method of confirming myocardial ischaemia is by demonstrating specific electrical changes on a 12-lead ECG. This is used in patients presenting to the hospital with chest pain, and can also be adapted to being performed during exercise in patients who get symptoms reliably during exertion. However, there is a large cohort of patients who get sporadic and brief episodes of angina at times when it is not feasible to carry out an ECG (such as at home). These patients face a diagnostic conundrum.
Novel ambulatory ECG (aECG) monitoring devices are now being increasingly utilised in patients with suspected rhythm disturbances, such as atrial fibrillation. These devices also have the potential to detect the electrical changes that occur due to myocardial ischaemia. The advantage of these devices is that they can be carried around by patients in the community and activated by patients when they notice chest pain; therefore, they can be used to meet the unmet demands of the patient cohort described above. However, despite there being anecdotal evidence from case reports, aECG monitoring devices have not been validated to detect myocardial ischaemia and, furthermore, their diagnostic utility in detecting ischaemia in comparison to a gold standard is not known. This study aims to address this knowledge gap by comparing the diagnostic utility of specific aECG monitoring devices in detecting myocardial ischaemia in patients with confirmed ischaemia on a 12-lead ECG in patient.
REC name
London - Queen Square Research Ethics Committee
REC reference
23/LO/0136
Date of REC Opinion
11 May 2023
REC opinion
Further Information Favourable Opinion