Abstract Body (Do not enter title and authors here): Introduction/Background
Acute coronary syndrome (ACS) is potentially a life-threatening emergency, and prompt diagnosis and reperfusion are essential to prevent adverse outcomes. Individuals with ACS can experience an array of symptoms which may be non-specific. The emergence of new technology for home-based monitoring of cardiac electrical activity (rhythm and ischemia) may supplement individuals’ symptom appraisal, improve diagnostic accuracy, and reduce prehospital delay. The feasibility of individuals with ACS to acquire their own electrocardiogram (ECG) using remote cardiac monitoring is unknown. The purpose of this pilot study was to evaluate if hospitalized patients could acquire a derived 12-lead ECG using a KardiaMobile 6L remote cardiac monitoring device.

Methods/Approach
Hospitalized patients >21 years of age at high risk for ischemic events (e.g., ACS diagnosis, HEART score >3) who owned a smart phone were included. After consent, research assistants trained participants, using apps on their own smart phones, to 1) acquire an ECG with KardiaMobile 6L, at least once daily, for the duration of their hospitalization, and 2) document symptoms with the validated 13-item ACS Symptom Checklist following ECG acquisition.

Results/Data
Between November 2024 - June 2025, we enrolled 27 participants (mean age 64.8 years; ± 11.4). The sample was 29.6% female, 74.1% White, 40.7% transported by ambulance, and 44.4% admitted to ICU. Mean length of stay was 5.26 ±4.42 days. Most (88.9%) were diagnosed with an ACS condition: STEMI (33.3%), NSTEMI (44.4%), or unstable angina (11.1%). Of 26 patients with complete KardiaMobile data, 25 (96.2%) acquired at least one ECG, 9 (39%) completed an ECG on every day of hospitalization, and 13 (50%) completed an ECG on at least half of the days. A blinded cardiologist classified a majority of KardiaMobile ECGs as clean and interpretable (90.4%). All 27 participants submitted at least one ACS Symptom Checklist, with patients submitting an average of 2.6 ±1.9 checklists.

Conclusions
In this ongoing study, preliminary results suggest hospitalized patients can successfully use a KardiaMobile 6L device to capture derived 12-lead ECGs. KardiaMobile 6L demonstrates potential for detecting critical ECG changes relevant to ACS. Future studies are needed to examine ECG acquisition and transmission from home and remote evaluation (e.g., telehealth) for early ischemia detection and response (i.e., call 911) among community dwelling adults.