Prevalence of cardiac arrhythmias in pre-hospital tele-cardiology electrocardiograms of emergency medical service patients referred for syncope

Brunetti, Natale Daniele; Dellegrottaglie, Giulia; Antonelli, G; Amoruso, Daniele

doi:10.1016/j.jelectrocard.2012.07.018

Cited by 26 publications

(24 citation statements)

References 22 publications

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“…2 , 3 The onset of arrhythmia is often associated with other chronic diseases and may cause complications such as stroke. Abnormal electrocardiographic (ECG) findings are also seen in patients with syncope, 4 a condition associated with twofold increased mortality in the population. 5 Atrial fibrillation (AF) is a common arrhythmia that is reported to have a prevalence of 1.5%–3% in the general population in the developed world 6 , 7 and ∼20% in the oldest population.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

Lindberg

Bohman

Elmståhl

et al. 2016

CIA

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PurposeWith longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom®.MethodsTwo hundred elderly persons aged 66–93 years were recruited from the Swedish National Study on Aging and Care in 2010–2013, and data were collected via wireless LTR ECG-BodyKom.ResultsScreening with the LTR ECG revealed that persistent atrial fibrillation (AF) occurred in 10% of the outpatient population aged ≥66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60–80 years) and older (>80 years) elderly participants. Furthermore, all patients with paroxysmal AF had a CHA2DS2VASc score of ≥2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it.ConclusionThe increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment.

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Section: Introductionmentioning

confidence: 99%

Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

Lindberg

Bohman

Elmståhl

et al. 2016

CIA

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“…Prior studies have shown that prehospital triage with telemedicine support could be useful in the prompt diagnosis and treatment of acute MI, 21,23 arrhythmias, 27,28 and syncope. 29 Prehospital ECG may allow the early detection of false-negative MI (subjects with STEMI without typical chest pain; about 20%, with increasing rates in elderly, according to some series 22 ) and false-positive MI (subjects with chest pain without ST-segment elevation not requiring immediate reperfusion; about 96%, according to other series 23 ) in the case of suspected acute myocardial infarction. Telemedicine might also have an important role as part of a strategy for the delivery of effective health care for patients with heart failure.…”

Section: Discussionmentioning

confidence: 99%

Prehospital Telemedicine Electrocardiogram Triage for a Regional Public Emergency Medical Service: Is It Worth It? A Preliminary Cost Analysis

Brunetti

Dellegrottaglie²,

Lopriore³

et al. 2014

Clinical Cardiology

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Background: Telemedicine has been shown to improve quality of health-care delivery in several fields of medicine; its cost-effectiveness, however, is still a matter of debate. Hypothesis: Pre-hospital telemedicine electrocardiogram triage for regional public emergency medical service may reduce costs. Methods: An economic evaluation (cost analysis) was performed from the perspective of regional health-care system. Patients enrolled in the study and considered for cost analysis were those who called the local emergency medical service (EMS; dialing 1-1-8) during 2012 and underwent prehospital field triage with a telemedicine electrocardiogram (ECG) in the case of suspected acute cardiac disease (acute coronary syndrome, arrhythmia). The prehospital ECGs were read by a remote cardiologist, available 24/7. Cost savings associated with this method were calculated by subtracting the cost of prehospital triage with telemedicine support from the cost of conventional emergency department triage (ECG and consultation by a cardiologist). Results: During 2012, the regional EMS performed 109 750 ECGs by telemedicine support. The associated total cost for the regional health-care system was ¤1 833 333, with a ¤16.70 cost per single ECG/consultation. Given the cost of similar conventional emergency department treatment from a regional rate list of ¤24.80 to ¤55.20, the savings was ¤8.10 to ¤38.40 per ECG/consultation (total savings, ¤891 759.50 to ¤4 219 379.50). The cost for ruling out an acute cardiac disease was ¤25.30; for a prehospital diagnosis of cardiovascular disease, ¤49.20. With 629 prehospital diagnoses of ST-elevation myocardial infarction and reported reductions in mortality thanks to prehospital diagnosis deduced from prior studies, 69 lives per year presumably could be saved, with a cost per quality-adjusted life year gained of ¤1927, ¤990/¤ − 2508 after correction for potential savings.Conclusions: Prehospital EMS triage with telemedicine ECG in patients with suspected acute cardiac disease may reduce health-care costs.

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“…6 Prehospital ECG recordings and the use of telemetry-based ECG interpretation are important not only for STEMI patients, but also for patients referred for syncope, stroke, or any suspicion of arrhythmia. [7][8][9] The most severe clinical expression of cardiac arrhythmias is represented by sudden cardiac death (SCD). The estimated incidence of SCD is around 50-100 cases per 100,000 persons per year, and approximately 80% of the cases are caused by ventricular arrhythmias such as ventricular tachycardia and fibrillation.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Cardiac Rhythm and Conduction Abnormalities Diagnosed in Mobile Emergency Units in Central Romania

Masalar¹,

Linga

Crişan

et al. 2017

Journal of Cardiovascular Emergencies

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Prevalence of cardiac arrhythmias in pre-hospital tele-cardiology electrocardiograms of emergency medical service patients referred for syncope

Cited by 26 publications

References 22 publications

Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

Prehospital Telemedicine Electrocardiogram Triage for a Regional Public Emergency Medical Service: Is It Worth It? A Preliminary Cost Analysis

Characteristics of Cardiac Rhythm and Conduction Abnormalities Diagnosed in Mobile Emergency Units in Central Romania

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