Impact of field-transmitted electrocardiography on time to in-hospital thrombolytic therapy in acute myocardial infarction.
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Date
1990-11-19
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Abstract
To assess the impact of a field transmitted electrocardiogram ECG on patients with possible acute myocardial infarction randomized and open trials were performed with a portable electrocardiographic system coupled with a cellular phone programmed to automatically transmit ECGs to the base hospital Consecutive patients served by the 6 units of the Salt Lake City Emergency Rescue System were studied 71 patients were randomized to in field ECG n 34 versus no ECG n 37 Time on scene was 16 4 9 7 minutes for the ECG group versus 16 1 7 0 minutes for the non ECG group difference not significant Time of transport averaged 18 2 9 9 and 17 6 13 1 minutes respectively difference not significant Six of 34 patients with in field ECG showed acute myocardial infarction qualified for and received thrombolytic therapy at 48 12 minutes after hospital arrival range 30 to 60 compared with 103 44 minutes p less than 0 01 for 51 historical control patients and 68 29 minutes for 6 concurrent control patients without in field ECG Thus in field ECG causes negligible delays in paramedic time leads to significant decreases in time to in hospital thrombolysis and may make in field therapy feasible In field ECG may be an important addition to reperfusion strategies