Validation of 12-lead tele-electrocardiogram transmission in the real-life scenario of acute coronary syndrome.
A 12-lead electrocardiogram (ECG) recorded in patients with acute coronary syndrome (ACS) was transmitted to a call centre via telephone (tele-ECG). In 120 patients (mean age 64 years) referred to hospitals because of ACS, a standard 12-lead ECG and a tele-ECG recorded at the same time were compared by two cardiologists and one internist independently and blindly. Conduction times exhibited very good agreement between standard and tele-ECG with reliability coefficients (R) of 0.91, 0.86 and 0.89 for the PQ-, QRS- and QT interval, respectively. Rhythm analysis was correct in 99% of the cases. Negative T waves, ST-segment elevation and depression were detected with very high agreement in the tele-ECG exhibiting kappa (kappa) coefficients between 0.75 and 0.96. The correct ECG diagnosis of ST-elevation myocardial infarction (STEMI) was possible with excellent agreement between standard and tele-ECG, showing kappa coefficients of 0.96, 0.99 and 0.99, respectively, for three investigators. The 12-lead tele-ECG recorder proved accurate for the detection of acute STEMI.
Schwaab
Bernhard
B
Department of Cardiology and Cardiovascular Rehabilitation, Curschmann Klinik, Timmendorfer Strand, Germany. schwaab@drguth.de
Katalinic
Alexander
A
Richardt
Gert
G
Kurowski
Volkhard
V
Krüger
Dietmar
D
Mortensen
Kai
K
Lorenz
Eduard
E
Sheikhzadeh
Abdolhamid
A
D000208:Acute Disease; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods / Q000592:standards*; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D010865:Pilot Projects; D015203:Reproducibility of Results; D013577:Syndrome; D017216:Telemedicine / Q000592:standards*; D013686:Telemetry