Validation of 12-lead tele-electrocardiogram transmission in the real-life scenario of acute coronary syndrome

• Published in: Journal of telemedicine and telecare Vol. 12; no. 6; p. 315
• Main Authors: Schwaab, Bernhard, Katalinic, Alexander, Richardt, Gert, Kurowski, Volkhard, Krüger, Dietmar, Mortensen, Kai, Lorenz, Eduard, Sheikhzadeh, Abdolhamid
• Format: Journal Article
• Language: English
• Published: England 01.09.2006
• Subjects: Acute Disease; Coronary Disease - diagnosis; Coronary Disease - physiopathology; Electrocardiography - methods; Electrocardiography - standards; Emergency Medical Services - methods; Emergency Medical Services - standards; Female; Humans; Male; Myocardial Infarction - diagnosis; Myocardial Infarction - physiopathology; Pilot Projects; Reproducibility of Results; Syndrome; Telemedicine - standards; Telemetry
• ISSN: 1357-633X
• DOI: 10.1258/135763306778558204

A 12-lead electrocardiogram (ECG) recorded in patients with acute coronary syndrome (ACS) was transmitted to a call centre via telephone (tele-ECG). In 120 patients (mean age 64 years) referred to hospitals because of ACS, a standard 12-lead ECG and a tele-ECG recorded at the same time were compared by two cardiologists and one internist independently and blindly. Conduction times exhibited very good agreement between standard and tele-ECG with reliability coefficients (R) of 0.91, 0.86 and 0.89 for the PQ-, QRS- and QT interval, respectively. Rhythm analysis was correct in 99% of the cases. Negative T waves, ST-segment elevation and depression were detected with very high agreement in the tele-ECG exhibiting kappa (kappa) coefficients between 0.75 and 0.96. The correct ECG diagnosis of ST-elevation myocardial infarction (STEMI) was possible with excellent agreement between standard and tele-ECG, showing kappa coefficients of 0.96, 0.99 and 0.99, respectively, for three investigators. The 12-lead tele-ECG recorder proved accurate for the detection of acute STEMI.