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Comparative Study
. 2024 May 27;48(1):57.
doi: 10.1007/s10916-024-02077-9.

Comparison Between a Single-Lead ECG Garment Device and a Holter Monitor: A Signal Quality Assessment

Luca Neri #  1   2 , Ivan Corazza #  2 , Matt T Oberdier #  1 , Jessica Lago  2 , Ilaria Gallelli  2 , Arrigo F G Cicero  2   3 , Igor Diemberger  2   4 , Alessandro Orro  5 , Amir Beker  6 , Nazareno Paolocci  1   7 , Henry R Halperin  1   8   9 , Claudio Borghi  10   11
Affiliations
Comparative Study

Comparison Between a Single-Lead ECG Garment Device and a Holter Monitor: A Signal Quality Assessment

Luca Neri et al. J Med Syst. .

Abstract

Wearable electronics are increasingly common and useful as health monitoring devices, many of which feature the ability to record a single-lead electrocardiogram (ECG). However, recording the ECG commonly requires the user to touch the device to complete the lead circuit, which prevents continuous data acquisition. An alternative approach to enable continuous monitoring without user initiation is to embed the leads in a garment. This study assessed ECG data obtained from the YouCare device (a novel sensorized garment) via comparison with a conventional Holter monitor. A cohort of thirty patients (age range: 20-82 years; 16 females and 14 males) were enrolled and monitored for twenty-four hours with both the YouCare device and a Holter monitor. ECG data from both devices were qualitatively assessed by a panel of three expert cardiologists and quantitatively analyzed using specialized software. Patients also responded to a survey about the comfort of the YouCare device as compared to the Holter monitor. The YouCare device was assessed to have 70% of its ECG signals as "Good", 12% as "Acceptable", and 18% as "Not Readable". The R-wave, independently recorded by the YouCare device and Holter monitor, were synchronized within measurement error during 99.4% of cardiac cycles. In addition, patients found the YouCare device more comfortable than the Holter monitor (comfortable 22 vs. 5 and uncomfortable 1 vs. 18, respectively). Therefore, the quality of ECG data collected from the garment-based device was comparable to a Holter monitor when the signal was sufficiently acquired, and the garment was also comfortable.

Keywords: Electrocardiogram; Holter monitor; Signal quality; Wearable devices.

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Conflict of interest statement

The co-author A.B. is employed by AccYouRate Group, which is a company that is producing wearable technology that analyzes ECG signals on a mobile platform.

Figures

Fig. 1
Fig. 1
The YouCare device is a garment with polymer-based sensors directly integrated in the garment fabric. When in direct contact with the skin, the device can record a single-lead ECG through sensors in the belt around and below the chest. There are two versions, one for men (A) and one for women (B) with different sizes. The garment is connected to the control unit, that works as an acquisition and transmission module, (C, D) through four snaps (E). Polymer-based sensors provide contact with the skin (F)
Fig. 2
Fig. 2
ECG quality assessment using data recorded with the YouCare device for each patient. These percentages do not include data lost due to Bluetooth disconnections
Fig. 3
Fig. 3
Representative ECG signals recorded with the YouCare classified as: A. “Good” – all ECG waveform features (P, QRS, and T) are visible; B. “Acceptable” – the QRS is visible; C. “Not Readable” – mostly noise with no ECG waveforms clearly visible
Fig. 4
Fig. 4
Example of overlapped tachograms from the YouCare device and the Holter monitor
Fig. 5
Fig. 5
Representative ECG signals with arrhythmias from the YouCare device (above, in blue) and Holter monitor (below, in orange)
Fig. 6
Fig. 6
Comfort comparison between the YouCare and Holter devices
See this image and copyright information in PMC

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