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[Telemedicine in the transmission of prehospitalisation ECGs of patients with suspected acute myocardial infarction].

INTRODUCTION
Time to reperfusion is critical to the outcome of patients with ST-elevation myocardial infarction (MI). Other studies have indicated that wireless transmission of prehospital ECGs can reduce the time to reperfusion. This study evaluated the effect on time to treatment using prehospitalisation ECG transmission to a cardiologist's handheld device in patients with acute chest pain, as well as the potential effect of direct transfer of patients to the closest appropriate cardiological facility.


MATERIALS AND METHODS
During a one-year study period, prehospitalisation ECGs were transmitted for all patients with symptoms indicative of acute coronary syndrome. The ECGs were received on a handheld device by an attending cardiologist, and the patient was referred to PCI treatment if ST-elevation was found.


RESULTS
152 transmissions were registered; 27 of these patients underwent primary PCI treatment. 135 (89%) of the attempted transmissions were successful. Compared to historic controls, there was an increased on-scene time usage of 7 minutes, including transfer. The median time spent from arrival at the hospital to the start of invasive treatment was low, 22 minutes. Compared to historic controls, we found a total reduction in time spent of 72 minutes (p< 0.01).


DISCUSSION
The results indicate that it is possible to minimize the time delay to primary PCI treatment by direct transfer through consultation and use of wireless transmission of prehospitalisation-acquired ECGs to a handheld device carried by an attending cardiologist.