Key result
Mobile 6-lead ECG reliably assesses PQ intervals, potentially cutting DM1 outpatient visits by ~37%.
Why the study?
Cardiac involvement occurs in approximately 80% of patients with myotonic dystrophy type 1, but whether a mobile 6-lead ECG device could accurately triage prolonged ECG intervals compared with routine 12-lead ECG was unknown.
Does a mobile 6-lead ECG device accurately measure PQ and QRS intervals compared to routine 12-lead ECG in patients with myotonic dystrophy type 1?
Cross-Sectional (n=100)
Does a mobile 6-lead ECG device accurately measure PQ and QRS intervals compared to routine 12-lead ECG in patients with myotonic dystrophy type 1?
Effect estimate: ICC 0.80 (95% CI 0.72-0.86)
A mobile 6-lead ECG device can accurately measure PQ intervals in DM1 patients, potentially serving as a triage tool to reduce routine outpatient visits.
May support mobile ECG PQ triage in DM1; leaves open prospective validation before practice change.
Background and aims Cardiac involvement occurs in approximately 80% of patients with myotonic dystrophy type 1 (DM1), and annual follow-up with a routine 12‑lead ECG (rECG) is recommended. We assessed a mobile 6‑lead ECG device (mECG) as a triage tool to identify DM1 patients with suspected prolonged ECG intervals, validating the feasibility and accuracy of mECG-derived PQ and QRS intervals against rECG. Methods This supervised in-clinic proof-of-concept study included 50 patients with DM1 and 50 cardiology patients from the cardiology outpatient clinic. All underwent rECG and mECG during a single routine visit. Agreement was assessed using correlation, intra-class correlation coefficient (ICC), and Bland-Altman analyses. Results Median [IQR] age was 56 [40–66] years; 45% were women. mECG-derived PQ and QRS intervals correlated moderately to strongly with rECG (Pearson's r = 0.83 and 0.74; ICC = 0.80 and 0.74). Bland-Altman analyses showed mean differences of −2 ms (PQ) and − 14 ms (QRS). The 95%-sensitivity thresholds for detecting prolonged rECG PQ intervals was 175 ms. Consulting only DM1 patients exceeding these limits would potentially reduce hospital visits by 37%. QRS demonstrated the highest systematic bias. Conclusion mECG is feasible in patients with DM1 and provides reliable assessment of PQ intervals. Integrated into annual cardiac follow-up, it could serve as a triage tool, potentially reducing outpatient visits by 37% for DM1. This may become increasingly valuable as novel DM1 therapies expand the population requiring regular cardiac surveillance. QRS triage is unsuitable in its current form.
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Bovenkerk et al. (2026) conducted a cross-sectional in Myotonic dystrophy type 1 (DM1) (n=100). Mobile 6-lead ECG device (KardiaMobile 6L) vs. Routine 12-lead ECG was evaluated on Agreement of mECG-derived PQ intervals with rECG (ICC 0.80, 95% CI 0.72-0.86). A mobile 6-lead ECG device provided reliable assessment of PQ intervals compared to routine 12-lead ECG (ICC 0.80), potentially reducing outpatient visits by 37% for patients with myotonic dystrophy type 1.
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