Pre-Hospital Diagnosis of Myocardial Ischaemia by Telecardiology: Safety and Efficacy of a 12-Lead Electrocardiogram, Recorded and Transmitted by the Patient
| Autor: | Bernhard Schwaab, Alexander Katalinic, Abdolhamid Sheikhzadeh, Jens Riedel |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Myocardial ischaemia Time delays 020205 medical informatics Cardiology Myocardial Ischemia 12 lead electrocardiogram Health Informatics 02 engineering and technology Electrocardiography 03 medical and health sciences QRS complex 0302 clinical medicine Germany Internal medicine 0202 electrical engineering electronic engineering information engineering medicine Humans Telemetry ST segment cardiovascular diseases 030212 general & internal medicine Myocardial infarction Aged business.industry Middle Aged medicine.disease Telemedicine Self Care Physical therapy Female business Kappa Standard ECG |
| Zdroj: | ResearcherID |
| ISSN: | 1758-1109 1357-633X |
| Popis: | We compared a 12-lead electrocardiogram (ECG) recorded by the patient and transmitted to a cardiology call centre via telephone (tele-ECG) with a standard 12-lead ECG recorded from the same patient at the same time. In 158 patients, tele-ECGs were compared with standard ECGs by two cardiologists and one internist, independently and blindly. In 14 patients peripheral electrodes were displaced, and in 12 patients there were baseline artefacts. These technical errors were corrected by telephone communication in all but two individuals. One patient could not use the tele-ECG device because of disability. Hence, in 155 of 158 patients (98%), the quality of the tele-ECG was adequate for diagnosis. Reliability coefficients ( R) for PQ, QRS and QT intervals between tele- and standard ECG were high, with R values of 0.73, 0.75 and 0.79, depending on the physician. Negative T-waves could be detected with very good agreement in the tele-ECG as compared with the standard ECG (kappa values of 0.97, 0.95 and 0.94). The agreement between tele- and standard ECG concerning: alterations of the ST segment was very good (kappa = 0.99 for all investigators). Residual signs of myocardial infarction could be detected by tele-ECG, with very good agreement for anterior as well as for posterior localizations (kappa = 0.99 and 1.00). The tele-ECG technique seems a promising approach to reducing pre- and in-hospital time delays to the initiation of thrombolytic therapy. |
| Databáze: | OpenAIRE |
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