Time to reperfusion in ST-segment elevation myocardial infarction patients with vs. Without pre-hospital mobile telemedicine 12-lead electrocardiogram transmission

Shoji Kawakami, Yoshio Tahara, Teruo Noguchi, Nobuhito Yagi, Yu Kataoka, Yasuhide Asaumi, Michio Nakanishi, Yoichi Goto, Hiroyuki Yokoyama, Hiroshi Nonogi, Hisao Ogawa, Satoshi Yasuda

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Background: Prehospital ECG improves survival following ST-segment elevation myocardial infarction (STEMI). Although a new International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations placed new emphasis on the role of prehospital ECG, this technology is not widely used in Japan. We developed a mobile telemedicine system (MTS) that continuously transmits real-time 12-lead ECG from ambulances in a prehospital setting. This study was designed to compare reperfusion delay between STEMI patients with different prehospital transfer pathways. Methods and Results: Between 2008 and 2012, 393 consecutive STEMI patients were transferred by ambulance to hospital (PCI-capable center); 301 patients who underwent primary percutaneous coronary intervention (PCI) were enrolled prospectively. We compared time to reperfusion between patients transferred to PCI-capable hospital using the MTS (MTS group, n=37), patients directly transferred from the field to PCI-capable hospital without the MTS (field transfer group, n=125) and patients referred from a PCI-incapable hospital (interhospital transfer group, n=139). Times to reperfusion in the MTS group were significantly shorter than in the other groups, yielding substantial benefits in patients who arrived at a PCI-capable hospital within 6 h after symptom onset. On multivariate analysis, MTS use was an independent predictor of <90-min door-to-device interval (OR, 4.61; P=0.005). Conclusions: Reperfusion delay was shorter in patients using MTS than in patients without it.

Original languageEnglish
Pages (from-to)1624-1633
Number of pages10
JournalCirculation Journal
Volume80
Issue number7
DOIs
Publication statusPublished - 2016
Externally publishedYes

Keywords

  • Door-to-device interval
  • Percutaneous coronary intervention
  • Reperfusion
  • ST-segment elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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