Lower mortality with pre-hospital electrocardiogram triage by telemedicine support in high risk acute myocardial infarction treated with primary angioplasty: Preliminary data from the Bari–BAT public Emergency Medical Service 118 registry

Brunetti, Natale Daniele; Bisceglia, Lucia; Dellegrottaglie, Giulia; Bruno, Angela Ivana; Pietro, Gaetano Di; Gennaro, Luisa De; Biase, Matteo Di

doi:10.1016/j.ijcard.2015.03.138

Cited by 20 publications

(18 citation statements)

References 36 publications

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“…(12) However, in higher risk AMI patients, pre-hospital tele-ECG triage has been associated with a lower 6-month mortality. (12) In our study, we did not use a control group to compare the performance of pre-hospital tele-ECG since we used the general population in primary care settings as our study population.…”

Section: Discussionmentioning

confidence: 99%

“…(14) In developed countries, both pre-and in-hospital tele-ECG triage signi cantly shorten door-to-balloon time in patients with acute myocardial infarction and result in higher rates of timely primary percutaneous coronary intervention (PCI) (< 90 minutes), compared to the control group. (12,15,16) Tele-ECG has been relevantly proved to reduce unnecessary hospitalization and wrong diagnosis in the case of suspected acute CVD. (14) To our knowledge, the present study is among the rst to explore the implementation of telemedicine programs in South-East Asia, and couples the program performance to patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: The first experience from Makassar Telemedicine Program, Indonesia

Mappangara

Qanitha

Uiterwaal

et al. 2020

Preprint

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Background: Telemedicine has been a popular tool to overcome the lack access to healthcare facilities, primarily in underprevilaged populations. We aimed to describe and assess the implementation of tele-electrocardiography (ECG) program in primary care settings in Indonesia, and subsequently examine the short- and mid-term outcomes of patients those received tele-ECG consultation.Methods: A total of 505 ECG recordings from thirty primary care centers were transmitted to Makassar Cardiac Center, Indonesia from January to July 2017. We prospectively collected data by sending a detailed questionnaire to general practitioners (GPs). Follow-up was performed at 30 days and at the end of follow-up on October 2018.Results: Of 505 recordings, all (100%) ECGs were qualified for analysis, and about a half showed normal findings. Ischemia presented in 15.6%, arrhythmia in 23.6%, and abnormalities compatible with structural changes in 5.1%. The mean age of participants was 53.3 ± 13.6 years, and 40.2% were male. Most (73.9%) of these primary care patients turned up with a manifasted CVD symptom with at least one risk factor. More men had an ischemic ECG compare to women (p<0.01), while aged >55 years was associated with ischemic or arrhythmic ECG (p<0.05). Factors significantly associated with a normal ECG were younger age, female gender, lower blood pressure and heart rate, and no history of previous cardiovascular disease (CVD) or medication. More patients with an abnormal ECG had a history of hypertension, known diabetes, and were current smokers (p<0.05). Majority (95%) of GPs were satisfied with each tele-ECG consultation, and 58.6% used tele-ECG for an expert opinion. Over the total follow-up (14 ± 6.6 months), seven (1.4%) patients died and 96 (19.0%) were hospitalized for CVD. Of 88 patients for whom hospital admission was advised, 72 (81.8%) were immediately referred within 48 hours following the tele-ECG consultation. Conclusions: Tele-ECG can be implemented in Indonesian primary care settings with limited resources and may assist the GPs for immediate triage, results in higher rate of early hospitalization for indicated patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: The first experience from Makassar Telemedicine Program, Indonesia

Mappangara

Qanitha

Uiterwaal

et al. 2020

Preprint

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“…In an Italian provincial network for the treatment of STEMI, treatment times were significantly reduced in the group using telemedicine diagnosis compared with controls 148 ± 81 min vs. 262 ± 112 37 . Reducing the time of treatment seems to significantly affect the prognosis, especially in patients with increased risk of complications and more unstable medical conditions, cardiogenic shock, 40 more comorbidities, 41 more severe Killip class 36 …”

Section: Telemedicine For the Reduction Of Time To Treatment: Supportmentioning

confidence: 99%

ANMCO/SIT Consensus Document: telemedicine for cardiovascular emergency networks

Caldarola

Gulizia

Gabrielli³

et al. 2017

European Heart Journal Supplements

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Telemedicine has deeply innovated the field of emergency cardiology, particularly the treatment of acute myocardial infarction. The ability to record an ECG in the early prehospital phase, thus avoiding any delay in diagnosing myocardial infarction with direct transfer to the cath-lab for primary angioplasty, has proven to significantly reduce treatment times and mortality. This consensus document aims to analyse the available evidence and organizational models based on a support by telemedicine, focusing on technical requirements, education, and legal aspects.

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“…Zusammenfassung ! Die Nutzung der EKG-Telemetrie führt zu einer verbesserten Herzinfarktversorgung [17,18]. Nur durch eine flächendeckende Etablierung von Herzinfarktnetzen, die qualitätsmäßig überwacht und mit telemetriebasierten Behandlungspfaden ausgestattet sind, kann eine weitere Senkung der Mortalität bei Patienten mit akutem STEMI erreichten werden.…”

Section: Vorteile Der Ekg-telemetrieunclassified

Telemedizin aus dem Notarztwagen verbessert die Versorgungsstruktur bei Herzinfarkt

Schwinger

2016

Aktuel Kardiol

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Zusammenfassung Die Nutzung der EKG-Telemetrie f?hrt zu einer verbesserten Herzinfarktversorgung 17,?18. Nur durch eine fl?chendeckende Etablierung von Herzinfarktnetzen, die qualit?tsm??ig ?berwacht und mit telemetriebasierten Behandlungspfaden ausgestattet sind, kann eine weitere Senkung der Mortalit?t bei Patienten mit akutem STEMI erreichten werden. Um das Ziel einer fl?chendeckenden Telemetriem?glichkeit zu gew?hrleisten, ist auch von den Kostentr?gern eine entsprechende Unterst?tzung gefordert. Die Grundbausteine der Telemedizin aus dem Notarztwagen sind somit vorhandene verl?ssliche Technik, funktionierende Algorithmen und eine hohe Akzeptanz durch die Beteiligten. Das Erreichte muss durch regelm??ige Feedback-Veranstaltungen und Schulungsma?nahmen permanent reevaluiert und ggf. angepasst werden.

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Lower mortality with pre-hospital electrocardiogram triage by telemedicine support in high risk acute myocardial infarction treated with primary angioplasty: Preliminary data from the Bari–BAT public Emergency Medical Service 118 registry

Cited by 20 publications

References 36 publications

Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: The first experience from Makassar Telemedicine Program, Indonesia

Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: The first experience from Makassar Telemedicine Program, Indonesia

ANMCO/SIT Consensus Document: telemedicine for cardiovascular emergency networks

Telemedizin aus dem Notarztwagen verbessert die Versorgungsstruktur bei Herzinfarkt

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