Abstract
Cold stress can affect ventricular repolarization (VR), which may serve as a potential trigger for malignant arrhythmias. Compared to conventional electrocardiogram (ECG) devices, wearable technology is more suitable for out-of-hospital monitoring due to their portability. However, outdoor cold environments can limit their application. We aimed to develop a wearable ECG capable of functioning in a cold environment. Moreover, to explore the impact of cold stress on VR parameters in a real-world cold environment and identify associated cardiovascular risks. A self-developed handheld 12-lead wearable ECG was utilized, featuring a fabric electrode and a novel "sandwich" design to enhance its applicability in cold environments. A total of 152 healthy adults were enrolled and both conventional and wearable ECG were performed on them. The results from testing under an outdoor cold environment indicated that the parameters of the ECG measured by the wearable device were in good agreement with those measured by the conventional machine. Those with higher baseline heart rate (HR) were at increased risk of prolonged QT(c), TpTe(c,) and TpTe/QT when compared to those with lower baseline HR after exposure to a cold environment, potentially enabling risk stratification for arrhythmia-prone populations, thereby reducing the incidence of sudden cardiac death.