Time to Reperfusion in ST-Segment Elevation Myocardial Infarction Patients With vs. Without Pre-Hospital Mobile Telemedicine 12-Lead Electrocardiogram Transmission

Shoji Kawakami; Yoshio Tahara; Teruo Noguchi; Nobuhito Yagi; Yu Kataoka; Yasuhide Asaumi; Michio Nakanishi; Yoichi Goto; Hiroyuki Yokoyama; Hiroshi Nonogi; Hisao Ogawa; Satoshi Yasuda

doi:10.1253/circj.CJ-15-1322

Ischemic Heart Disease

Time to Reperfusion in ST-Segment Elevation Myocardial Infarction Patients With vs. Without Pre-Hospital Mobile Telemedicine 12-Lead Electrocardiogram Transmission

Shoji Kawakami, Yoshio Tahara, Teruo Noguchi, Nobuhito Yagi, Yu Kataoka, Yasuhide Asaumi, Michio Nakanishi, Yoichi Goto, Hiroyuki Yokoyama, Hiroshi Nonogi, Hisao Ogawa, Satoshi Yasuda

Author information

Shoji Kawakami
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Yoshio Tahara
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Teruo Noguchi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Nobuhito Yagi
Department of Cardiology, Okinawa Chubu Hospital
Yu Kataoka
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Yasuhide Asaumi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Michio Nakanishi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Yoichi Goto
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Hiroyuki Yokoyama
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Hiroshi Nonogi
Shizuoka General Hospital
Hisao Ogawa
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Satoshi Yasuda
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University

Keywords: Door-to-device interval, Percutaneous coronary intervention, Reperfusion, ST-segment elevation myocardial infarction

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Supplementary material

2016 Volume 80 Issue 7 Pages 1624-1633

DOI https://doi.org/10.1253/circj.CJ-15-1322

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Abstract

Background:Prehospital ECG improves survival following ST-segment elevation myocardial infarction (STEMI). Although a new International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations placed new emphasis on the role of prehospital ECG, this technology is not widely used in Japan. We developed a mobile telemedicine system (MTS) that continuously transmits real-time 12-lead ECG from ambulances in a prehospital setting. This study was designed to compare reperfusion delay between STEMI patients with different prehospital transfer pathways.Methods and Results:Between 2008 and 2012, 393 consecutive STEMI patients were transferred by ambulance to hospital (PCI-capable center); 301 patients who underwent primary percutaneous coronary intervention (PCI) were enrolled prospectively. We compared time to reperfusion between patients transferred to PCI-capable hospital using the MTS (MTS group, n=37), patients directly transferred from the field to PCI-capable hospital without the MTS (field transfer group, n=125) and patients referred from a PCI-incapable hospital (interhospital transfer group, n=139). Times to reperfusion in the MTS group were significantly shorter than in the other groups, yielding substantial benefits in patients who arrived at a PCI-capable hospital within 6 h after symptom onset. On multivariate analysis, MTS use was an independent predictor of <90-min door-to-device interval (OR, 4.61; P=0.005).Conclusions:Reperfusion delay was shorter in patients using MTS than in patients without it. (Circ J 2016; 80: 1624–1633)

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