ECG transmission from ambulance cuts time to direct clot removal

DURHAM, N.C. When emergency medical technicians (EMTs) wirelessly transmit eletrocardiograms (ECG) directly to a cardiologist's hand-held device, heart attack patients can potentially receive direct clot removal in half the usual time, according to cardiologists at Duke University Medical Center and NorthEast Medical Center, Concord, N.C.

Cutting this "door-to-reperfusion" time is critical, the cardiologists said, because the sooner a patient suffering from a heart attack receives an artery-opening procedure, the more likely heart muscle can be saved, and that the patient will potentially derive a survival benefit.

While the American College of Cardiology (ACC) and the American Heart Association recommend that patients have their arteries opened directly within 90 minutes of arriving at the hospital the NorthEast Medical Center team was able to cut that time to 50 minutes. The national average "door-to-reperfusion" is about 100 minutes, the researchers said.

The results of the pilot project were presented March 13, 2006, by Duke Clinical Research Institute cardiology fellow George Adams, M.D., during the 55th annual scientific sessions of the ACC in Atlanta. His study is one of five finalists for an ACC Young Investigator Award.

The team achieved this significant time savings by directly linking EMTs with cardiologists and bypassing the hospital's emergency department for the small proportion of those patients with chest pain whose ECG is distinctly diagnostic. In the current study, specially trained EMTs transmitted ECG tracings electronically from the scene or in the ambulance to an on-call cardiologist's personal digital assistant (PDA). The cardiologist -- on spotting the definitive signs of a heart attack -- could mobilize the catheterization laboratory while the patient was en route to the hospital.

While the time savings achieved in the current pilot project are significant, the researchers point out that the results

Contact: Richard Merritt
Duke University Medical Center

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