ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction (STAT-MI) Trial

OBJECTIVES:The purpose of the present study was to implement eventHolter tele-ECG system in small-town area with poor access to healthcare. METHODS:One hundred patients aged over 55 with suspected arrhythmia were studied for one month, using 4-electrode event-Holter device. The study protocol included 3-times daily acquisition of ECG during complaints. For the period of observation patients were supported by a technical help-desk, psychologist, dietician and physicians. RESULTS:During this study patients recorded over 7000 ECGs, with pathology rate of 19%. Quality of recordings remained high (88% ECGs of good quality), and patient's satisfaction was excellent. Clinical impact was reflected in change of treatment in 16 patients, referring to cardiology clinic in 4 patients or cardiac ambulatory treatment in 33 individuals. CONCLUSION: We found event-Holter monitoring as a valuable tool, that may be helpful in daily arrhythmia management. Prolonged time of acquisition may help to register arrhythmia otherwise remaining undetected.

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“…in our study). Successful transmission-rate was 100%, which corresponds to the current results of leading research (18).…”

Section: Discussionsupporting

confidence: 73%

Long-term event-Holter monitoring in low-populated areas as a valuable diagnostic tool in the detection of arrhythmia

HaraÅczyk¹,

KonieczyÅska²,

PÅazak³

2017

Curr Res Cardiol

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“…25,33,36,47,48,53 Interventions of prehospital cardiac care were evaluated in five studies, and three studies investigated the impact of prehospital 12-lead electrocardiograms (ECGs). 26,27,30 One study investigated prehospital AMI diagnosis, 53 and a study evaluate protocol for percutaneous coronary intervention (PCI) bypass. 30 The majority of these studies demonstrate a positive correlation between DST and impact on patient assessment.…”

Section: Discussionmentioning

confidence: 99%

Decision-Support Tool in Prehospital Care: A Systematic Review of Randomized Trials

Hagiwara

Henricson

Jönsson

et al. 2011

Prehosp. Disaster med.

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Objective: The objective of this study was to evaluate the effects of the decision support tool (DST) on the assessment of the acutely ill or injured out-of-hospital patient. Methods: This study included systematic reviews of randomized controlled trials (RCT) where the DST was compared to usual care in and out of the hospital setting. The databases scanned include: (1) Cochrane Reviews (up to January 2010); (2) Cochrane Controlled Clinical Trials (1979 to January 2010); (3) Cinahl (1986 to January 2010); and (4) Pubmed/ Medline (1926 to January 2010). In addition, information was gathered from related magazines, prehospital home pages, databases for theses, conferences, grey literature and ongoing trials. Results: Use of the DST in prehospital care may have the possibility to decrease "time to definitive care" and improve diagnostic accuracy among prehospital personnel, but more studies are needed. Conclusions:The amount of data in this review is too small to be able to draw any reliable conclusions about the impact of the use of the DST on prehospital care. The research in this review indicates that there are very few RCTs that evaluate the use of the DST in prehospital care. IntroductionPrehospital patient assessment is different compared to assessments provided in hospitals. Often, the ambulance personnel are sent to medical emergencies with very little background information. The person who initiates the call for help sometimes is not able to describe the situation, and therefore, the ambulance personnel have difficulties preparing themselves for the task. The ambulance personnel's work situation has been described as "extreme". "They have routinely required working in environments of extreme and constant uncertainty." 1 These environmental factors lead to great strain on the prehospital caregiver's ability when assessing patients. In addition, there have been very few randomized controlled trials (RTC) that have evaluated prehospital care. 2 When 14 ambulance nurses in Sweden were asked about factors that influence their decision-making, several factors that were crucial for the decision were elicited. Important factors included: (1) time of day; (2) season and weather; (3) amount of time before other resources could arrive to the scene; (4) if there was threat of security; (5) stress; (6) environment; (7) diagnosis and; (8) type of patient assessed. 3 A qualitative study by Wireklint Sundström described the need of an "open mind" in the performance of prehospital assessments, and noted that prehospital caregivers must put their preconceived ideas aside when they meet and assess patients. 4 As assessments and treatments of patients in prehospital emergency medical care are becoming more advanced and complex, prehospital emergency care is on the eve of a new and emerging role. 5 Many organizations are searching for alternatives to Accident and Emergency (A&E) treatments, 6 but according to a recent systematic review, prehospital personnel's preparedness for this task is poor. 7 Another future task ...

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“…The second report was focused on the implementation of an automated wireless network for the transmission of prehospital electrocardiograms (ECGs) as a means to reduce doorto-balloon times in acute ST-segment elevation myocardial infarctions (STEMIs). 70 STEMI is the most severe type of heart attack and constitutes a true medical emergency. The system consisted of Bluetooth devices, preprogrammed transmitting/ receiving stations, dedicated e-mail servers, and smartphones.…”

Section: New Evidencementioning

confidence: 99%

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

Bashshur

Krupiński

Thrall

et al. 2016

Telemedicine and e-Health

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Introduction: Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. Methods: A selective review of the credible literature during the past decade (2005-2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. Findings: The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.

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ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction (STAT-MI) Trial

Abstract: 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.

Cited by 124 publications

References 13 publications

Long-term event-Holter monitoring in low-populated areas as a valuable diagnostic tool in the detection of arrhythmia

Long-term event-Holter monitoring in low-populated areas as a valuable diagnostic tool in the detection of arrhythmia

Decision-Support Tool in Prehospital Care: A Systematic Review of Randomized Trials

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

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