Document Detail


Effectiveness of prehospital wireless transmission of electrocardiograms to a cardiologist via hand-held device for patients with acute myocardial infarction (from the Timely Intervention in Myocardial Emergency, NorthEast Experience [TIME-NE]).
MedLine Citation:
PMID:  17056318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction (STEMI) decreases morbidity and mortality if performed within the first 2 hours of symptom onset. However, the American College of Cardiology/American Heart Association guideline for percutaneous coronary intervention door-to-balloon time (<90 minutes) in patients with STEMI is a infrequently accomplished goal. This study enrolled 277 patients with STEMI who were self-transported or transported by emergency medical services to NorthEast Medical Center for primary percutaneous coronary intervention. This study tested the hypothesis that prehospital wireless transmission of an electrocardiogram to a cardiologist's hand-held device results in shorter emergency department door-to-reperfusion time. A comparison was made between patients whose electrocardiogram was successfully transmitted during the intervention phase with (1) patients transported by the emergency medical services in the preintervention, (2) patients self-transported in the intervention phase, and (3) patients whose wireless transmission failed in the intervention phase. During the preintervention phase (2001 to 2003), 48 patients were enrolled. During the intervention phase (2003 to 2005), the following patients were enrolled: 101 self-transported patients, 24 patients with successful electrocardiographic transmission, and 19 patients for whom transmission failed. The median door-to-reperfusion time for patients with successful electrocardiographic transmission was 50 minutes, which was significantly shorter than a preintervention time of 101 minutes (p <0.0001), an intervention phase self-transport time of 96 minutes (p <0.0001), and a failed transmission time of 78 minutes (p <0.0001). In conclusion, prehospital wireless electrocardiographic transmission to a cardiologist's hand-held device significantly decreased emergency department door-to-reperfusion time, thus achieving the American College of Cardiology/American Heart Association guideline for patients with STEMI.
Authors:
George L Adams; Paul T Campbell; John M Adams; David G Strauss; Karen Wall; Janet Patterson; Kathy B Shuping; Charles Maynard; Dwayne Young; Craig Corey; Alan Thompson; Benjamin A Lee; Galen S Wagner
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-08-31
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-23     Completed Date:  2006-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1160-4     Citation Subset:  AIM; IM    
Affiliation:
Duke University Medical Center, Durham, North Carolina, USA. adams104@mc.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Artificial Intelligence
Cardiology*
Computers, Handheld*
Coronary Stenosis / diagnosis,  therapy
Electrocardiography*
Emergency Medical Service Communication Systems*
Endpoint Determination
Equipment Design
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  therapy*
Myocardial Reperfusion
North Carolina
Pilot Projects
Prospective Studies
Signal Processing, Computer-Assisted
Time Factors
Transportation of Patients
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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