Electrocardiogram sonification accelerates detection of ST elevation myocardial infarction compared to analysis based solely on visual display: a randomized controlled simulation study with medical students
Dublin Core
Title
Electrocardiogram sonification accelerates detection of ST elevation myocardial infarction compared to analysis based solely on visual display: a randomized controlled simulation study with medical students
Subject
Electrocardiogram, ECG, ST elevation myocardial infarction, STEMI, Sonification, Biosignal monitoring,
Acute coronary syndrome
Acute coronary syndrome
Description
Purpose A 12 lead electrocardiogram (ECG) is the standard diagnostic method for the detection of an acute coronary
syndrome, as it is also used in emergency medical services. A novel sonification method can convert an important
part of the ECG signal into an acoustic signal: The ST segment sonification is particularly useful for the detection of
transient ST elevations in patients with suspicion of acute coronary syndrome. A quick and accurate detection of
transient ECG changes of the ST segment is prerequisite for proper treatment, thus having immediate therapeutic
consequences.
Methods As part of an emergency training program, a cohort of n = 44 medical students was recruited to
participate in a two-part study. Some of them, namely n = 32 of the total 44 subjects, participated in a second
part of the study, an RCT, which we report on here. The diagnostic accuracy recently estimated in a classification
study involving all 44 subjects with regard to acoustically presented ECG sequences of varying degrees of severity
of ST-elevation myocardial infarction forms the background for the RCT described here. The n = 32 subjects who
participated in the RCT were randomly assigned in two-person teams to either an intervention (n = 8 teams of two)
or a control (n = 8 teams of two) arm, respectively, whereby all teams, except for one dropout due to a technical
failure in the intervention arm, went through an emergency simulation where they had to detect an emerging ST
elevation myocardial infarction. The intervention group was endowed with a sonification-assisted equipment whereas
the control group used standard visual-based ECG diagnosis only.
Results An adjusted multivariable regression yielded a statistically significant reduction for the intervention group
of the delay time from starting a first ECG to the correct diagnosis by 163 seconds (p = 0.002) corresponding to
syndrome, as it is also used in emergency medical services. A novel sonification method can convert an important
part of the ECG signal into an acoustic signal: The ST segment sonification is particularly useful for the detection of
transient ST elevations in patients with suspicion of acute coronary syndrome. A quick and accurate detection of
transient ECG changes of the ST segment is prerequisite for proper treatment, thus having immediate therapeutic
consequences.
Methods As part of an emergency training program, a cohort of n = 44 medical students was recruited to
participate in a two-part study. Some of them, namely n = 32 of the total 44 subjects, participated in a second
part of the study, an RCT, which we report on here. The diagnostic accuracy recently estimated in a classification
study involving all 44 subjects with regard to acoustically presented ECG sequences of varying degrees of severity
of ST-elevation myocardial infarction forms the background for the RCT described here. The n = 32 subjects who
participated in the RCT were randomly assigned in two-person teams to either an intervention (n = 8 teams of two)
or a control (n = 8 teams of two) arm, respectively, whereby all teams, except for one dropout due to a technical
failure in the intervention arm, went through an emergency simulation where they had to detect an emerging ST
elevation myocardial infarction. The intervention group was endowed with a sonification-assisted equipment whereas
the control group used standard visual-based ECG diagnosis only.
Results An adjusted multivariable regression yielded a statistically significant reduction for the intervention group
of the delay time from starting a first ECG to the correct diagnosis by 163 seconds (p = 0.002) corresponding to
Creator
Jens Tiesmeier1*, Friederike Tielking2
, Steffen Grautoff3,4, Jan Persson2
, Hans H. Diebner5*, Thomas P. Weber6
and
Thomas Hermann7
, Steffen Grautoff3,4, Jan Persson2
, Hans H. Diebner5*, Thomas P. Weber6
and
Thomas Hermann7
Source
https://doi.org/10.1186/s12873-025-01466-8
Date
2026
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Jens Tiesmeier1*, Friederike Tielking2
, Steffen Grautoff3,4, Jan Persson2
, Hans H. Diebner5*, Thomas P. Weber6
and
Thomas Hermann7, “Electrocardiogram sonification accelerates detection of ST elevation myocardial infarction compared to analysis based solely on visual display: a randomized controlled simulation study with medical students,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12065.