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2023年1月 第26卷 第2期 http: //www.chinagp.net E-mail: zgqkyx@chinagp.net.cn ·193·

26（2）：192-200，209. ［www.chinagp.net］
YU X Y，ZHAO X D，ZHAO X Y，et al. Diagnostic accuracies of three schemes for arrhythmia screening using a wearable
single-lead ECG monitoring system：a real-world community-based study［J］. Chinese General Practice，2023，26（2）：
192-200，209.

Diagnostic Accuracies of Three Schemes for Arrhythmia Screening Using a Wearable Single-lead ECG Monitoring
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System：a Real-world Community-based Study YU Xinyan ，ZHAO Xudong ，ZHAO Xiaoye ，LIU Haipeng ，JIANG
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Qingru ，ZHANG Haicheng 5*
1.Health Management & Physical Examination Center，the First People's Hospital of Yinchuan，Yinchuan 750001，China
2.Xinhua Subdistrict Community Health Center，the First People's Hospital of Yinchuan，Yinchuan 750001，China
3.School of Electrical and Information Engineering，North Minzu University，Yinchuan 750021，China
4.Center for Intelligent Healthcare，Coventry University，Coventry CV1 5FB，UK
5.Department of Cardiology，Peking University People's Hospital，Beijing100044，China
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Corresponding author：ZHANG Haicheng，Chief physician；E-mail：haichengzhang@bjmu.edu.cn
【Abstract】 Background Arrhythmia has a high incidence，and is a serious threat to human health. However，due
to concealed symptoms and unpredictability of onset，it is difficult for traditional ECG equipment to capture the ECG data at the
onset of the arrhythmic events，so it could be misdiagnosed and under-treated. Fortunately，the diagnosis rate of arrhythmia could
be greatly enhanced by analyzing the uploaded real-time ECG data of individuals measured at home using the wearable single-lead
ECG monitoring system under the guidance of community doctors，but there is a lack of relevant evidence from real-world studies.
Objective To assess the diagnostic accuracies of three schemes for screening arrhythmia in the community using a wearable
single-lead ECG monitoring system. Methods A real-world，community-based study design was used for comparing three
schemes for screening arrhythmia using a wearable single-lead ECG monitoring system：scheme 1 was used for collecting 24-hour
ECG data on any three nonconsecutive days in two weeks，scheme 2 was used for collecting 24-hour ECG data on any day and at
least three 1-hour ECG data in two weeks，and scheme 3 was adopted for collecting 72-hour ECG data on any three consecutive
days and at least one 1-hour ECG data on any one day in two weeks. Subjects were 435 community-living residents，who were
recruited from Yinchuan from September 2020 to September 2021. They were divided into male group（177 cases），female
group（258 cases）；young group （135 cases），middle-aged group （200 cases） and elderly group （100 cases） by age；
primary school group （77 cases），middle school group （165 cases） and university group （193 cases） by educational
level； arrhythmia group （233 cases） and non-arrhythmia group （202 cases） by the history of arrhythmia. Subjects measured
the ECG either at the onset time of perceived arrhythmia or not using any one of the three screening schemes chosen voluntarily
with the wearable single-lead ECG monitoring system，then uploaded the measurement results to the cloud platform. The number
of participants using each of the three screening schemes was counted. The correlation of age，education level or history of
arrhythmia with scheme selection was analyzed. And detection rates of the three screening schemes were compared. Results The
number of subjects who selected the three screening schemes was 321，40 and 74，respectively. The average age of the subjects
was significantly different（P=0.047）. There was no correlation between gender，education level，medical history and protocol
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selection （χ =0.670，P=0.715；χ =2.994，P=0.559；χ =2.225，P=0.893）. There was a significant correlation between
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different age groups and protocol selection （χ =9.939，P=0.041）. The arrhythmia detection rates of the three screening
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protocols were 85.67%，82.50% and 85.14%，respectively，and the difference was not statistically significant （χ =0.286，
P=0.867）. There was no significant difference in the arrhythmia detection rate between the male group and the female group
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（χ =0.966，P=0.707；χ =0.917，P=0.678）. There was no significant difference in the detection rate of arrhythmia among
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young group，middle-aged group and elderly group（χ =2.102，P=0.350；χ =0.871，P=0.706；χ =1.063，P=0.622）.
There was no significant difference in the detection rate of arrhythmia among the three screening schemes in primary school
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group，middle school group and university group（χ =2.421，P=0.271；χ =1.115，P=0.633；χ =2.181，P=0.353）.
There was no significant difference in the arrhythmia detection rate between the three screening protocols in the history group and
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the no history group （χ =1.442，P=0.507；χ =0.548，P=0.818）. The frequency of 1-hour ECG data collection in protocol
2 was positively correlated with arrhythmia detection rate （r s =0.912，P=0.011）. The frequency of 1-hour ECG data collection
in protocol 3 was positively correlated with arrhythmia detection rate （r s =0.852，P=0.026）. In protocol 2，the detection rate of
arrhythmia in 24-hour ECG data was 72.5%，and that in 1-hour ECG data was 77.5%. There was a strong consistency between the
two kinds of long-term ECG data（Kappa=0.601，P=0.001）. In protocol 3，the arrhythmia detection rate of 72-hour ECG data