title: Cellular video-phone assisted transmission and interpretation of prehospital 12-lead electrocardiogram in acute st-segment elevation myocardial infarction.
abstract: BACKGROUND
  Prehospital 12-lead electrocardiogram (ECG) reduces the time to reperfusion in acute ST-segment elevation myocardial infarction (STEMI). However, the reliability of using cellular video-phone (VP) assisted interpretation of ECG is unknown.
  
  
  METHODS
  We studied the interphysician reliability in interpreting the ECG assisted with VP compared to print ECG interpretation. Twenty-seven physicians prospectively interpreted the ECG transmitted from the field in real-time using VP and later using the same printed ECG. The time to completion, accuracy of interpretation, and physician rating of the VP technology were recorded.
  
  
  RESULTS
  Similar high interphysician reliability was observed with both VP assisted and printed ECG interpretation including presence of ST-segment elevation (intraclass correlation coefficient [ICC]= 0.98 [95% CI 0.96-1] vs. 0.99 [95% CI 0.99-1]) and pathologic Q wave (ICC = 0.99 [95% CI 0.98-1] vs. 1 [95% CI 1]), respectively. The mean time to transmit and interpret the ECG with VP versus printed ECG was 3.9 ± 1.9 versus 2.1 ± 0.9 minutes, respectively, P < 0.01. On a scale of 1 to 5 with 5 being the best, the average rating of VP ease of use was 4.4 ± 0.5 and utility to recommend treatment was rated a 5.
  
  
  CONCLUSIONS
  Cellular VP-assisted transmission and interpretation in real-time of prehospital ECG has high interphysician reliability, similar to the printed ECG interpretation. Future studies testing whether VP decreases the ischemic time and expedites the reperfusion of STEMI patients are needed.
authors: Washington Hospital Center, Washington, DC 20010, USA.
authors: Manuel A
authors: MA
authors: Gonzalez
authors: Lowell F
authors: LF
authors: Satler
authors: Maria E
authors: ME
authors: Rodrigo
authors: Michael A
authors: MA
authors: Gaglia
authors: Itsik
authors: I
authors: Ben-Dor
authors: Gabriel
authors: G
authors: Maluenda
authors: Nicholas
authors: N
authors: Hanna
authors: William O
authors: WO
authors: Suddath
authors: Rebecca
authors: R
authors: Torguson
authors: Augusto D
authors: AD
authors: Pichard
authors: Ron
authors: R
authors: Waksman
mesh_terms: D040421:Cell Phone / Q000295:instrumentation*; D004562:Electrocardiography / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis*; D010865:Pilot Projects; D015203:Reproducibility of Results; D017216:Telemedicine; D014741:Video Recording / Q000379:methods*