ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction (STAT-MI) trial.
OBJECTIVE
Our goal was to examine the effects of implementing a fully automated wireless network to reduce door-to-intervention times (D2I) in ST-segment elevation myocardial infarction (STEMI).


BACKGROUND
Wireless technologies used to transmit prehospital electrocardiograms (ECGs) have helped to decrease D2I times but have unrealized potential.


METHODS
A fully automated wireless network that facilitates simultaneous 12-lead ECG transmission from emergency medical services (EMS) personnel in the field to the emergency department (ED) and offsite cardiologists via smartphones was developed. The system is composed of preconfigured Bluetooth devices, preprogrammed receiving/transmitting stations, dedicated e-mail servers, and smartphones. The network facilitates direct communication between offsite cardiologists and EMS personnel, allowing for patient triage directly to the cardiac catheterization laboratory from the field. Demographic, laboratory, and time interval data were prospectively collected and compared with calendar year 2005 data.


RESULTS
From June to December 2006, 80 ECGs with suspected STEMI were transmitted via the network. Twenty patients with ECGs consistent with STEMI were triaged to the catheterization laboratory. Improvement was seen in mean door-to-cardiologist notification (-14.6 vs. 61.4 min, p < 0.001), door-to-arterial access (47.6 vs. 108.1 min, p < 0.001), time-to-first angiographic injection (52.8 vs. 119.2 min, p < 0.001), and D2I times (80.1 vs. 145.6 min, p < 0.001) compared with 2005 data.


CONCLUSIONS
A fully automated wireless network that transmits ECGs simultaneously to the ED and offsite cardiologists for the early evaluation and triage of patients with suspected STEMI can decrease D2I times to <90 min and has the potential to be broadly applied in clinical practice.
Division of Cardiology, Department of Medicine, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA.
Vivek N
VN
Dhruva
Samir I
SI
Abdelhadi
Ather
A
Anis
William
W
Gluckman
David
D
Hom
William
W
Dougan
Edo
E
Kaluski
Bunyad
B
Haider
Marc
M
Klapholz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016507:Cardiology Service, Hospital / Q000592:standards; D003195:Computer Communication Networks; D017023:Coronary Angiography / Q000592:standards; D004562:Electrocardiography / Q000295:instrumentation*; D004631:Emergency Medical Service Communication Systems; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D013686:Telemetry; D013997:Time Factors