Clinical stage of acquired immunodeficiency syndrome in HIV-positive patients impacts the quality of the touch ECG recordings.

ABSTRACT

INTRODUCTION: HIV patients are at higher risk for cardiovascular disease and cardiac arrhythmias which can be recorded by a handheld single­lead ECG device. Quality of ECG depends on the skin condition, which worsens with the progression of HIV infection. OBJECTIVE: To study the quality of the ECG signal acquired by a mobile ECG device in patients with different clinical stages of human immunodeficiency virus (HIV) infection. PATIENTS AND METHODS: We studied the quality of 30-second single lead ECGs obtained by a handheld ECG device (Kardia; AliveCor Inc., San Francisco, USA) in 263 Kenyan adults (203 women) in various stages of HIV. The recordings were made during routine check-ups at the outpatient clinics. ECG quality was categorized as readable (not interfering with clinical interpretation) or unreadable (impossible clinical interpretation). The progression of the HIV infection was estimated using the World Health Organization AIDS Clinical Staging (WACS) scale, ranging from stage 1 (asymptomatic generalized lymphadenopathy) to stage 4 (wasting syndrome and Kaposi sarcoma). RESULTS: The median age of patients was 46 (39-53) years. ECG was readable in 201 patients (76.4%) and unreadable in 62 (23.6%). The WACS score > 1 was associated with 3.95 odds ratio (95% confidence interval 2.14-7.29; p < 0.0001) for the acquiring an unreadable ECG (univariate logistic regression adjusted to age, sex, body mass index and time since HIV). CONCLUSIONS: ECG quality recorded by a touch ECG device worsens with advancing HIV infection. For this reason, the accuracy of arrhythmia diagnosis by mobile ECG appears to be limited in HIV patients.