Significant benefits of new communication technology for time delay management in STEMI patients

Studenčan, Martin; Alusik, Daniel; Plachý, Lukáš; Bajerovská, Ľubica; Ilavský, M.; Karas, Jozef; Kilianova, Adriana; Sykora, Juraj; Hosa, Vladimir; Kmeč, Ján; Slanina, Miroslav; Boguska, Daniela

doi:10.1371/journal.pone.0205832

Cited by 12 publications

(7 citation statements)

References 11 publications

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Section: Discussionmentioning

confidence: 99%

“…9 In a previous study, the systematic implementation of a communication technology that allowed paramedics an instantaneous ECG image and voice consultation with a cardiologist reduced the total ischemic interval from 241 to 181 min. 10 The biggest advantage of the C-ECG system is that cardiologists can simultaneously read the ECG waveforms and can decide whether emergency PCI is necessary or not. Therefore, preparation for emergency catheterization can be completed before the ambulance arrives at the hospital, and the patient can undergo PCI immediately in the catheterization room (Figure 5).…”

Section: Disclosuresmentioning

confidence: 99%

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

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Disclosuresmentioning

confidence: 99%

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

et al. 2019

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“…The transfer of ECG was associated with 92% technical success. There was a significant decrease in unwanted secondary STEMI transportations (34.32% vs. 12.9%, p < 0.001) and a significant reduction in the total ischemic interval (241 min vs. 181 min, p = 0.03) [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Regional STEMI Network in North Cairo (Egypt): Impact on The Management and Outcome of STEMI Patients

et al. 2023

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Background: Regional ST-segment–elevation myocardial infarction (STEMI) networks facilitate timely performance of primary percutaneous coronary intervention (PPCI), reduce mortality and improve outcomes. Few data exist on the feasibility and impact of regional STEMI networks in developing countries. Aim of the Work: The aim of this study was to examine the feasibility and impact of establishing a regional STEMI network on the management and outcomes of STEMI patients in north Cairo. Patients and Methods: A prospective observational study conducted on 352 patients presenting in North Cairo with confirmed diagnosis of STEMI within 48 hours of symptoms. Patients were divided into group I (n = 140) before and group II (n = 212) after establishment of the STEMI network. Both groups were compared as regards patients’ demographics, presentation, management and short-term outcomes. The north Cairo regional STEMI network was established among four governmental hospitals and the governmental ambulance was used for interhospital transfer. WhatsApp® was used for trans-network team communication. Results: Mean age of the study population was 55.4 ± 11.02 years and 286 (81.3%) were males. Mean time from chest pain to first medical contact did not change between the two groups (240 minutes; P = 0.36) while door to balloon mean time was reduced (from 54.3 to 44.1 minutes: P = 0.01). Use of thrombolytic therapy declined from 51 (36.4%) to 16 (7.5%) (P < 0.001) while primary PCI increased from 59.8% to 77.1% (p < 0.001). Left ventricular ejection fraction improved from 51.3 ± 10.7 to 55.4 ± 9.1 (P < 0.001), the mean time of CCU stay was reduced from a mean of 3.0 to 2.0 days (P < 0.001) and in-hospital mortality improved from 6.4% to 2.8% (P = 0.10). Conclusion: The establishment of the STEMI network in north Cairo was feasible and improved patients’ outcomes. Use of primary PCI increased and in-hospital mortality improved from after establishment of STEMI network.

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“…Although age-standardized death rates from CVD have shown a decreasing trend globally, CVD remains one of the primary causes of death [3]. To reduce the total ischemic time, as a major factor in short-and long-term mortality [1,4,5], early recognition, diagnosis, and reperfusion should be performed in a coordinated and complementary manner.…”

Section: Background and Significancementioning

confidence: 99%

Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial (Preprint)

Yoon¹,

Kim²,

Roh³

et al. 2020

Preprint

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BACKGROUND Cardiovascular disease is the leading cause of death worldwide. Early recognition, early diagnosis, and early reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. Absence of prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measuring and transmitting of P12ECG data, P12ECG use has not been widely established. OBJECTIVE The aim of this study was to verify the time-efficiency and feasibility of using a patchy-type 12-lead ECG measuring and transmitting device by an emergency medical technician (EMT) in the ambulance during patient transport. METHODS This was a prospective randomized crossover controlled study that was simulation-based and included 119 emergency medical technicians. Participants were randomly assigned to one of two groups. Group A first underwent experiments with a conventional device and then transferred to an intervention device, and group B first underwent experiments with an intervention device and then transferred to a conventional device. All tests were conducted inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of the ECG test application to the completion of sending the results. After the simulation test, participants were administered the System Usability Scale. RESULTS A total of 18 emergency medical technicians were recruited in this study, and the median age was 35 years old. The overall interval time for the conventional device was 254 s (interquartile range 247-270), whereas the overall interval time for the intervention device was 130 s (interquartile range 112-150) for significant differences (P<.001). Significant differences between the conventional device and intervention device were identified in all time intervals, and for all intervals except interval 1, the intervention device was found to be significantly faster. In interval 1, the conventional device was found to be faster than the intervention device (P=.034). CONCLUSIONS The capture and transmission of P12ECG data using patch-type ECG recorders in the transporting ambulance is faster compared with the use of a conventional defibrillator device. This study is registered at ClinicalTrials.gov (NCT04114760). CLINICALTRIAL This study was approved by the Samsung Medical Center Institutional Review Board (No. 2019-04-004) and registered at ClinicalTrials.gov (NCT04114760).

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Significant benefits of new communication technology for time delay management in STEMI patients

Cited by 12 publications

References 11 publications

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

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

Implementation of a Regional STEMI Network in North Cairo (Egypt): Impact on The Management and Outcome of STEMI Patients

Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial (Preprint)

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