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Novel electrocardiogram configurations and transmission procedures in the prehospital setting: effect on ischemia and arrhythmia determination

Drew, B. J. et al.

Journal of electrocardiology. VOL 39; NUMBER 4; SUPP, ; 2006, S157-S160 -- Elsevier Science B.V., Amsterdam (pages S157-S160) -- 2006

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  • Title:
    Novel electrocardiogram configurations and transmission procedures in the prehospital setting: effect on ischemia and arrhythmia determination
  • Author: Drew, B. J.;
    Sommargren, C. E.;
    Schindler, D. M.;
    Zegre, J.;
    Benedict, K.;
    Krucoff, M. W.
  • Found In: Journal of electrocardiology. VOL 39; NUMBER 4; SUPP, ; 2006, S157-S160
  • Journal Title: Journal of electrocardiology.
  • Subjects: Medicine; Biotechnology; Pharmaceutical Chemistry; LCC: RC681; Dewey: 616.1207547
  • Publication Details: Elsevier Science B.V., Amsterdam
  • Language: English
  • Abstract: AimThe aims of this report are to (1) describe a novel prehospital 12-lead electrocardiogram (ECG) configuration and transmission procedure used in the Synthesized Twelve-lead ST Monitoring and Real-time Tele-electrocardiography Study and to (2) report on the frequency of arrhythmias in field ECGs compared with the first hospital ECG.MethodsThe Synthesized Twelve-lead ST Monitoring and Real-time Tele-electrocardiography Study is a 5-year randomized clinical trial ending in 2008. All emergency vehicles responding to 911 calls in Santa Cruz County, Calif, have been equipped with portable monitor defibrillators with a special study software that (1) synthesizes a 12-lead ECG from 5 electrodes, (2) measures ST amplitudes in all 12 leads every 30 seconds, and (3) automatically transmits an ECG to the target emergency department if there is a change in ST amplitude of 200 μV in 1 lead or more or 100 μV in 2 contiguous leads or more lasting 2.5 minutes. An initial ECG is transmitted by paramedics, which activates the software. Subsequent transmissions of ST event ECGs occur automatically without paramedic decision making.ResultsPrehospital ECGs had a greater frequency of arrhythmias than the first hospital ECG in the group as a whole (n = 433; 33.3% vs 28.9%; P ≤ .001), as well as the subgroup with acute coronary syndrome (n = 185; 30.3% vs 26.5%; P ≤ .001). More tachyarrhythmias occurred in the field and slightly more bradyarrhythmias occurred at the time of the first hospital ECG.ConclusionsPrehospital continuous 12-lead ST-segment ischemia monitoring with computer-assisted automatic mobile telephone transmission of ST event ECGs to the target hospital is feasible. More arrhythmias occur in the prehospital phase than are evident on the first hospital ECG.
  • Identifier: Journal ISSN: 0022-0736
  • Publication Date: 2006
  • Physical Description: Electronic
  • Accrual Information: Quarterly
  • Shelfmark(s): 4974.750000
  • UIN: ETOCRN195032796

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