title: Referral of patients with ST-segment elevation acute myocardial infarction directly to the catheterization suite based on prehospital teletransmission of 12-lead electrocardiogram.
abstract: BACKGROUND
  Time from symptom onset to reperfusion is essential in patients with ST-segment elevation acute myocardial infarction. Prior studies have indicated that prehospital 12-lead electrocardiogram (ECG) transmission can reduce time to reperfusion.
  
  
  OBJECTIVE
  Determine 12-lead ECG transmission success rates, and time saved by referring patients directly to primary percutaneous coronary intervention (pPCI) bypassing local hospitals and emergency departments.
  
  
  METHODS
  Prehospital 12-lead ECG was recorded in patients with symptoms suggesting acute coronary syndrome during a 1-year pilot phase and transmitted to the attending cardiologist's mobile phone. Transmission success rates were determined, and prehospital and hospital delays were recorded and compared to historic controls.
  
  
  RESULTS
  Transmission was attempted in 152 patients and was successful in 89%. Twenty-seven patients were referred directly for pPCI. Median hospital arrival to pPCI was 22 vs 94 minutes in the control group (P < .01).
  
  
  CONCLUSIONS
  Transmission of prehospital ECG is technically feasible and reduces time to pPCI in ST-segment elevation acute myocardial infarction patients.
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Sillesen
authors.forename: Maria
authors.initials: M
authors.lastname: Sejersten
authors.forename: Søren
authors.initials: S
authors.lastname: Strange
authors.forename: Søren Loumann
authors.initials: SL
authors.lastname: Nielsen
authors.forename: Freddy
authors.initials: F
authors.lastname: Lippert
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen