Impact of Mobile Cloud Electrocardiography System on Door-to-Balloon Time in Patients With Acute Coronary Syndrome in Oita Prefecture

Abstract

Background: The mobile cloud electrocardiography (C-ECG) system is useful for reducing door-to-balloon (DTB) time in patients with acute coronary syndrome (ACS), but few studies have reported the usefulness of the C-ECG system across a wide provincial prefecture, such as Oita, in Japan. Methods and Results: On 17 April 2017, the C-ECG system was integrated into the Oita remote image transmission system, in 10 ambulances of 10 respective fire departments in Oita Prefecture. During 6 months, 162 ECG indicating suspected ACS were transmitted to 18 hospitals using the C-ECG system. Of 162 patients, 17 who received emergency percutaneous coronary intervention (PCI) were assigned to the cloud group (mean age, 71±11 years). The control group consisted of 29 consecutive ACS patients who were transported to Oita University Hospital without using the C-ECG system (mean age, 66±12 years). Another 40 consecutive patients were diagnosed with ACS before transportation to Oita University Hospital, and were assigned to the diagnosed group (mean age, 70±14 years). DTB time (70±26 min vs. 96±24 min, P<0.005) and door-to-catheterization laboratory time (33±20 min vs. 53±22 min, P<0.0001) were shorter in the cloud group than in the control group, respectively. Conclusions: C-ECG system integration in Oita Prefecture was useful to appropriately transfer ACS patients to hospital and to facilitate earlier PCI than in the conventional diagnostic system.

The Effectiveness of Mobile Cloud 12-Lead Electrocardiogram Transmission System in Patients with ST-Segment Elevation Myocardial Infarction

“…However, we reported FMCTB time was 80 (63-92) min in this study, even in the Conventional group. Similarly, door-to-balloon time and door-to-catheter laboratory time of prehospital-ECG group in the previous study were 68 (52-83) min and 27 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) min. However, those of the Conventional group in this study were 59 (38-67) min and 24 (15-41) min, espectively.…”

“…SCUNA is a MC-ECG transmission system [11][12][13]. SCUNA was shown to be effective for reducing door-to-balloon time in patients with acute coronary syndrome [28]. Previous studies, such as Kawakami et al, had reported in 2016 [29] that FMCTB time was 97 (82-112) min in the group with the use of prehospital electrocardiogram.…”

Prehospital 12-Lead Electrocardiography System in Oita Assisted Transport of “True” Acute Coronary Syndrome Patients to Optimal Institutes

“…The authors ascribed the results to a prehospital 12-lead ECG being performed reported that usage of C-ECG across a wide area of Oita, Japan, significantly reduced DTBT by 26 min and door-tocatheterization laboratory time by 20 min. 6 It is important to reduce the time from onset to reperfusion for a better outcome for patients with STEMI. The goal of treatment in STEMI is to achieve reperfusion within 120 min from onset, which means initiating therapy within 30 min from first contact with medical personnel for fibrinolysis in emergency department at hospital and catheter treatment to within 90 min from the first contact with medical personnel for PCI.…”

“…5 We used a mobile cloud electrocardiography system (C-ECG) as the prehospital 12-lead ECG and measured its effect on door-to-balloon times in Oita Prefecture. 6 Transmitting the prehospital 12-lead ECG by emergency teams to the hospital improve outcomes by enabling preparation of the cardiac catheterization room before patient arrival, early convening of the transmission system. The ECG in the cloud server can be accessed simultaneously from personal computers, smartphones, and tablets anywhere after access key authentication.…”

Application of Modern Multi-Sensor Holter in Diagnosis and Treatment

“…Today, the market offers single-channel or multi-channel Holters, with many complementary sensors, with or without a hospital certificate. Their price varies from tens of euros [42] to several thousands (EC-12H 12-Channel Holter ECG system by LabTech, Hungary or CardioMera ECG Holter Monitor, Medusoft, Australia) [43][44][45][46][47] depending on the quality and properties offered.…”