Smartphone ECG for evaluation of STEMI: Results of the ST LEUIS Pilot Study

© 2015 Elsevier Inc. All rights reserved.Background 12-lead ECG is a critical component of initial evaluation of cardiac ischemia, but has traditionally been limited to large, dedicated equipment in medical care environments. Smartphones provide a potential alternative platform for the extension of ECG to new care settings and to improve timeliness of care. Objective To gain experience with smartphone electrocardiography prior to designing a larger multicenter study evaluating standard 12-lead ECG compared to smartphone ECG. Methods 6 patients for whom the hospital STEMI protocol was activated were evaluated with traditional 12-lead ECG followed immediately by a smartphone ECG using right (VnR) and left (VnL) limb leads for precordial grounding. The AliveCor™ Heart Monitor was utilized for this study. All tracings were taken prior to catheterization or immediately after revascularization while still in the catheterization laboratory. Results The smartphone ECG had excellent correlation with the gold standard 12-lead ECG in all patients. Four out of six tracings were judged to meet STEMI criteria on both modalities as determined by three experienced cardiologists, and in the remaining two, consensus indicated a non-STEMI ECG diagnosis. No significant difference was noted between VnR and VnL. Conclusions Smartphone based electrocardiography is a promising, developing technology intended to increase availability and speed of electrocardiographic evaluation. This study confirmed the potential of a smartphone ECG for evaluation of acute ischemia and the feasibility of studying this technology further to define the diagnostic accuracy, limitations and appropriate use of this new technology.

Infused: Millennials and the Future of the Black Church

Deep societal trends impact the religious fervency and participation of millennials in the Black Church. Many young adults, though remaining Christian, have fallen away from their faith communities, finding them irrelevant for their daily lives. Even the most religiously committed have shown signs of waning faith, as evidenced by limited participation, and theological and ideological dissonance with the Black Church. Historically strong across all indicators, the Black Church is ideally positioned to stave off the attrition of youth and young adults, having a missional mindset toward this cohort—prioritizing them in their ministry development and programming. African American congregational leaders must develop disciples who have cohesive identities, live integrated lives, and experience an infusion of their personal vocation and the mission of the Church. Thus the future of the Black Church depends on the development of millennials who have an integrated faith life, which is distinguishable by its practices, disciplines, and virtues that are nurtured by an understanding of the Church’s mission and their role in it. Key will be establishing mentoring relationships that allow for questioning, exploration and discovery. To enact the changes necessary the church must understand the cultural worlds of young adults and engage them in holistic ministry that is reflective of the mission of God through Christ (missio dei)—activity that culminates with reaching the world with God’s redemptive plan for humanity.