ST Elevation Sonification of a 12-Lead ECG for the Assessment, Diagnosis, and Monitoring of ST Elevation Myocardial Infarction

We introduce a novel technique for the sonification/auditory representation of a 12-lead electrocardiogram (ECG), the standard diagnostic method for the detection of ST elevation myocardial infarction (STEMI). Our approach to ST elevation sonification conveys the detailed variation of the ST segment to enable differentiated, correct interpretation and severity without consulting a visual display. We present a variety of novel sonification designs and discuss their benefits and limitations. As part of an emergency training program, a cohort of 44 medical students (5th academic year) participated in a classification study in which the diagnostic accuracy of the participants was determined with regard to audibly presented ECG sequences of different STEMI severity levels. Regarding the classification of sonified ECG sequences, the discrimination of isoelectricity (IE, the healthy class) from all other (STEMI) classes combined yielded a perfect classification of all 660 classification instances (sensitivity = specificity = 1). With respect to the individual classification of all five classes (IE, inferior/anterior, and moderate/severe STEMI), an overall accuracy of 0.82 (0.79, 0.85) and an intraclass coefficient of κ=0.77 were estimated.