Evaluation of telemedicine in patients suspected of acute coronary syndrome at a non-invasive centre.

Mahmoud, Worud; Vestergaard, Lone Due; Schneider, Ida Ransby; Hansen, Vibeke Brogaard

INTRODUCTION The benefits of prehospital electrocardiograms (ECG) for patients with ST-elevation myocardial infarction (STEMI) are well-known. Evaluation of the present algorithm for prehospital ECG transmission is important to ensure correct and expeditious patient care. The purpose of this study was to evaluate ECGs transmitted from the prehospital setting to a non-invasive department of cardiology. METHODS At Lillebaelt Hospital, the cardiologist on-call evaluated and entered the transmitted ECGs and the associated transmission criteria into the Clinical Measurement System database (KMS). Furthermore, data from the KMS and the diagnoses at discharge were obtained from 2012 to 2015. RESULTS A total of 9,751 ECGs were included in the study. ECG transmission increased by 35% from year one to year three (p less-than 0.05). A total of 362 patients (3.7%) had STEMI. 25% of all ECGs were transmitted without any obvious cardiac symptom but produced a diagnosis of other cardiac illnesses than acute coronary syndrome in 28% of these patients. The number of ECGs sent per adult inhabitant in the area per year was 1:85. CONCLUSIONS A large number of ECGs are transmitted annually and at an increasing rate, and STEMI only comprises a very limited proportion of all transmitted ECGs to a non-invasive centre in Denmark. The high number of ECGs challenge the available resources, which are limited and should be used effectively, particularly in a period characterised by increased healthcare demands. FUNDING none. TRIAL REGISTRATION not relevant.