Telecardiology improves quality of diagnosis and reduces delay to treatment in elderly patients with acute myocardial infarction and atypical presentation

Abstract

Telecardiology home ECG diagnosis could significantly help in avoiding errors and delay in STEMI diagnosis in elderly patients.

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

“…Feasibility and reliability of telecardiology technologies applied to EMS have been already shown in previous studies that analyzed the effect of prehospital ECG screening in case of suspected acute myocardial infarction. 7,8 In these studies, pre-hospital ECG was particularly efficient in reducing the number of wrong diagnoses in older patients with ST-elevation acute myocardial infarction and atypical symptoms other than chest pain.…”

“…Pre-hospital ECG assessment with tele-medicine support of EMS patients may represent a reliable tool in avoiding wrong diagnosis and reducing delay to diagnosis, 7,8 identifying significant arrhythmias needing urgent hospitalization. In this study we therefore aimed to evaluate the prevalence of significant arrhythmias in EMS subjects referred for syncope, screened with pre-hospital ECG with tele-medicine support, potentially reducing the needing for ED cardiologic assessment.…”

Telemedicine for cardiovascular disease continuum: A position paper from the Italian Society of Cardiology Working Group on Telecardiology and Informatics

“…Pre-hospital electrocardiographic diagnosis and direct referral for primary PCI enables STelevation acute myocardial infarction patients living far from a PCI center and in rural areas to achieve a system delay comparable with patients living in close vicinity of a PCI center [20][21][22]. Immediate on field electrocardiogram screening may lower the rates of false negative diagnosis in the case of ST-elevation acute myocardial infarction with atypical presentation [23].…”

A Regional Prehospital Electrocardiogram Network with a Single Telecardiology “Hub” for Public Emergency Medical Service: Technical Requirements, Logistics, Manpower, and Preliminary Results

“…23 Clinical results and fields of application of telecardiology support for public EMS were previously published in several papers. 24,25 Prehospital ECG screening with telecardiology support reduced the rates of wrong or delayed diagnosis in elderly patients with AMI and atypical presentation. 25 In subjects with STEMI who called 118, 45% were diagnosed within 30 min of onset of chest pain, and 41% between 30 min and 3 h. 23 Sixty percent of patients with STEMI were diagnosed by prehospital 118 ECG in towns without an immediately accessible coronary care unit, thus particularly benefiting from an immediate diagnosis because of needing an immediate time-wasting transfer to a distant cath lab; 47% of these STEMI patients from small towns or in peripheral mountain areas were diagnosed within 30 min of onset of chest pain, and 87% within 3 h, with time to diagnosis similar to that in bigger towns.…”