title: Time to Reperfusion in ST-Segment Elevation Myocardial Infarction Patients With vs. Without Pre-Hospital Mobile Telemedicine 12-Lead Electrocardiogram Transmission.
abstract: BACKGROUND
  Prehospital ECG improves survival following ST-segment elevation myocardial infarction (STEMI). Although a new International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations placed new emphasis on the role of prehospital ECG, this technology is not widely used in Japan. We developed a mobile telemedicine system (MTS) that continuously transmits real-time 12-lead ECG from ambulances in a prehospital setting. This study was designed to compare reperfusion delay between STEMI patients with different prehospital transfer pathways.
  
  
  RESULTS
  Between 2008 and 2012, 393 consecutive STEMI patients were transferred by ambulance to hospital (PCI-capable center); 301 patients who underwent primary percutaneous coronary intervention (PCI) were enrolled prospectively. We compared time to reperfusion between patients transferred to PCI-capable hospital using the MTS (MTS group, n=37), patients directly transferred from the field to PCI-capable hospital without the MTS (field transfer group, n=125) and patients referred from a PCI-incapable hospital (interhospital transfer group, n=139). Times to reperfusion in the MTS group were significantly shorter than in the other groups, yielding substantial benefits in patients who arrived at a PCI-capable hospital within 6 h after symptom onset. On multivariate analysis, MTS use was an independent predictor of <90-min door-to-device interval (OR, 4.61; P=0.005).
  
  
  CONCLUSIONS
  Reperfusion delay was shorter in patients using MTS than in patients without it. (Circ J 2016; 80: 1624-1633).
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kawakami
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tahara
authors.forename: Teruo
authors.initials: T
authors.lastname: Noguchi
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Yagi
authors.forename: Yu
authors.initials: Y
authors.lastname: Kataoka
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Asaumi
authors.forename: Michio
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Goto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nonogi
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
mesh_terms: D000368:Aged; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D062645:Percutaneous Coronary Intervention; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods; D013997:Time Factors