justgetoffmylawn t1_itt8vwc wrote on October 26, 2022 at 3:19 AM

Reply to comment by Mitthrawnuruo in Doctor is ‘not a crazy Apple person’ and recommends lifesaving Apple Watch to every patient by prehistoric_knight

Like radiology, things like ECG interpretations will really benefit from machine learning on massive datasets. In both areas, we're not far away from an AI interpretation exceeding the abilities of a technician. Proof of concept has already shown neural networks outperforming resident doctors on 12-lead ECG interpretation.

Mitthrawnuruo t1_itu970t wrote on October 26, 2022 at 10:55 AM

Cool. So it is outperforming students. In telehealth network.

In a 3rd world country.

Additionally the article goes on to make several errors. I quote: “the S12L-ECG can provide a full evaluation of the cardiac electrical activity.”

This is not true. 15 lead EKGs are and have been for over decade a standard of care, especially if concern for a right sided MI, utilizing V4r, V5r, v6R. Then you have your 18 or more lead EKGs, that look at the posterior wall MIs.

Additionally, when you did farther. It becomes how simplistic the program is.

the S12L-ECG can provide a full evaluation of the cardiac electrical activity.

It only detects 6 “ abNormalities”: but when we break it down, only one even requires medical treatment based on the EKG, and the only other one that require treatment can be treated based solely on physical assessment.

First degree heart block. Sounds bad, but it just means it takes slightly longer for the electrical activity from the above AV node to travel through and below the AV node. It is an incidental finding. It isn’t treated, monitored,’or concerning.

Sinus tachycardia: drink to much Red Bull today? Go for a jog? Your in sinus tachycardia. It is just a normal sinus rhythm over >100. It isn’t concerning, and it isn’t treated (although the condition that caused it, such as pain; or dehydration, might be).

Sinus bradycardia: again, just a normal sinus rhythm, but slower then 60. It isn’t treated unless a person is symptomatic. IE; lightheaded or dizzy. Having chest pain due to hypotension. But you don’t need an EKG to tell you that. You could just take a pulse. Honesty, a pulse and blood pressure are more important. Treatment could be done entirely without an EKG, although cardiac monitoring would be preferable. You fix it with atropine, or you fix it would electrical stimulation (pacing)

Right and left BBB mean nothing, other then the normal electrical activity /pathway is abnormal. A LBBB makes it much harder to diagnose a STEMI (large heart attack) on the EKG.

There is a way to spot a mI on a patient with a LBBB, but I’ve read about it, studied it and can’t recognition it when I see it. I’m apparently not the only one; as the AHA recommendation is to treat it like. A heart attack unless is it KNOWN the patient has had a LBBB.

I don’t know anyplace that does this.

So….of those rhythms, only A-fib really la concern and gets treated. With blood thinners, and of course rate control.