AIM: To assess feasibility and reliability of telecardiology technologies applied to a region-wide public emergency health-care service. METHODS: About 27,841 patients from all over Apulia (19.362 km(2), 4 million inhabitants) were referred from October 2004 until April 2006 to public emergency health-care number "118" and underwent ECG evaluation according to a previously fixed inclusion protocol. Data recorded were transmitted with mobile telephone support to a telecardiology "hub" active 24-h a day. Hospitalization or further examinations were arranged by emergency physicians on the basis of ECG diagnosis and consultation. RESULTS: Thirty-nine percent of patients complained of chest pain (CP) or epigastric pain, 26% loss of consciousness, 10% breathlessness, and 7% palpitations. Atrial fibrillation (AF) was diagnosed in 11.68% of patients and ST-elevation acute myocardial infarction (STEMI) in 1.91%. Among patients with CP, ECG showed STEMI in only 3.84% of cases, theoretically eligible for fibrinolysis or primary PCI; patients with STEMI complained of CP in 78.94% of cases. Of the patients, 65.28% with STEMI were from small towns without coronary care units, thus benefiting from an immediate pre-hospital diagnosis. Among patients with palpitations, only 10.27% of subjects showed ECG signs of supra-ventricular tachycardia and 25.18% of AF; other subjects avoided further improper hospitalization or emergency department monitoring. CONCLUSIONS: This first region-wide leading experience shows the feasibility and reliability of telecardiology applied to a public emergency health-care service. Telemedicine protocols would probably be useful in lowering the number of improper hospitalizations and shortening delay in the diagnosis process of some heart diseases.
AIM: To assess feasibility and reliability of telecardiology technologies applied to a region-wide public emergency health-care service. METHODS: About 27,841 patients from all over Apulia (19.362 km(2), 4 million inhabitants) were referred from October 2004 until April 2006 to public emergency health-care number "118" and underwent ECG evaluation according to a previously fixed inclusion protocol. Data recorded were transmitted with mobile telephone support to a telecardiology "hub" active 24-h a day. Hospitalization or further examinations were arranged by emergency physicians on the basis of ECG diagnosis and consultation. RESULTS: Thirty-nine percent of patients complained of chest pain (CP) or epigastric pain, 26% loss of consciousness, 10% breathlessness, and 7% palpitations. Atrial fibrillation (AF) was diagnosed in 11.68% of patients and ST-elevation acute myocardial infarction (STEMI) in 1.91%. Among patients with CP, ECG showed STEMI in only 3.84% of cases, theoretically eligible for fibrinolysis or primary PCI; patients with STEMI complained of CP in 78.94% of cases. Of the patients, 65.28% with STEMI were from small towns without coronary care units, thus benefiting from an immediate pre-hospital diagnosis. Among patients with palpitations, only 10.27% of subjects showed ECG signs of supra-ventricular tachycardia and 25.18% of AF; other subjects avoided further improper hospitalization or emergency department monitoring. CONCLUSIONS: This first region-wide leading experience shows the feasibility and reliability of telecardiology applied to a public emergency health-care service. Telemedicine protocols would probably be useful in lowering the number of improper hospitalizations and shortening delay in the diagnosis process of some heart diseases.
Authors: David A Katz; Geoffrey C Williams; Roger L Brown; Tom P Aufderheide; Mark Bogner; Peter S Rahko; Harry P Selker Journal: Ann Emerg Med Date: 2005-07-14 Impact factor: 5.721
Authors: P B Berger; S G Ellis; D R Holmes; C B Granger; D A Criger; A Betriu; E J Topol; R M Califf Journal: Circulation Date: 1999-07-06 Impact factor: 29.690
Authors: Brahmajee K Nallamothu; Eric R Bates; Jeph Herrin; Yongfei Wang; Elizabeth H Bradley; Harlan M Krumholz Journal: Circulation Date: 2005-02-07 Impact factor: 29.690
Authors: J P Finley; G P Sharratt; M A Nanton; R P Chen; P Bryan; J Wolstenholme; C MacDonald Journal: J Telemed Telecare Date: 1997 Impact factor: 6.184
Authors: Pedro Galván; Miguel Velázquez; Gualberto Benítez; José Ortellado; Ronald Rivas; Antonio Barrios; Enrique Hilario Journal: Rev Panam Salud Publica Date: 2017-06-08