title: Telephonic transmission of 12-lead electrocardiograms during acute myocardial infarction.
abstract: To test the feasibility of a small and simple system for telephonic transmission of 12-lead electrocardiograms (ECGs), 70 patients with acute coronary syndrome admitted to the cardiac care unit (CCU) were included in a feasibility study. The transmission system consisted of a belt with multiple electrodes, which was positioned around the chest. The ECG signal was sent to a call centre via a standard telephone line. In parallel, a standard 12-lead ECG was recorded on site. In a retrospective analysis, each lead of the transmitted ECG was compared with the on-site 12-lead ECG with regard to ST-segment changes and final diagnosis. In all 37 patients with acute ST-elevation myocardial infarction, the diagnosis was correctly established on the basis of telephone-transmitted ECGs. In 96% of limb and 88% of chest leads, ST elevations which were visible in standard ECGs were correctly displayed on telephonically transmitted ECGs. In the remaining 33 patients no false-positive diagnosis was made using transtelephonic ECG analysis. A control group of 31 patients without apparent heart disease showed high concordance between standard ECGs and telephonically transmitted ECGs. Telephonically transmitted 12-lead ECGs interpreted by a hospital-based internist/cardiologist might allow a rapid and accurate diagnosis of ST-elevation myocardial infarction and may increase diagnostic safety for the emergency staff during prehospital decision making and treatment of acute myocardial infarction.
authors.affiliation: Department of Cardiology, University Hospital, RWTH Aachen University, Aachen, Germany. kmischke@ukaachen.de
authors.forename: K
authors.initials: K
authors.lastname: Mischke
authors.forename: M
authors.initials: M
authors.lastname: Zarse
authors.forename: M
authors.initials: M
authors.lastname: Perkuhn
authors.forename: C
authors.initials: C
authors.lastname: Knackstedt
authors.forename: K
authors.initials: K
authors.lastname: Markus
authors.forename: R
authors.initials: R
authors.lastname: Koos
authors.forename: T
authors.initials: T
authors.lastname: Schimpf
authors.forename: J
authors.initials: J
authors.lastname: Graf
authors.forename: P
authors.initials: P
authors.lastname: Hanrath
authors.forename: P
authors.initials: P
authors.lastname: Schauerte
mesh_terms: D000208:Acute Disease; D004562:Electrocardiography / Q000592:standards*; D015716:Electrocardiography, Ambulatory; D004632:Emergency Medical Services; D005240:Feasibility Studies; D005260:Female; D006327:Heart Block / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D013686:Telemetry / Q000592:standards*; D013689:Telephone / Q000592:standards*