Trans-telephonic electro-cardiographic monitoring (TTEM)--first Indian experience

Trans-Telephonic Electro-Cardiographic Monitoring (TTEM) centre, is an easy to use tool, now freely available in India. Between May 1996 and May 1997, 398 patients were registered at Escorts Heart Alert Centre (EHAC) for TTEM; 321 (81%) males and 77(19%) females. Age range was from 1 month to 95 years 65% patients were from New Delhi; 35% from other cities in India and abroad. Patients' clinical profile were post-CABG, post-PTCA, post-MI, patients after discharge; evaluation of chest pain, palpitation, chronic angina, arrhythmias, and pace-maker follow up. Out of 664 symptomatic transmissions, 510 (77%) were for cardiac symptoms like chest pain 309 (61%); palpitation 90 (18%); uneasiness 61(12%); dizziness 28(5%) breathlessness 22(4%). 154(23%) were for non-cardiac symptoms like stitch pain and backache (51); Atypical chest pain (39); weakness and fever (45) and sweating (19). 84%, 78% and 75% patients of chest pain, palpitation and dizziness respectively transmitted their ECGs within one hour of the onset of the symptoms. Out of 664 symptomatic transmissions, 531 required either re-assurance or drug-dose adjustment on telephone. 97 were called to OPD on elective basis. 36 patients were advised immediate hospitalization, for acute management. TTEM was useful in avoiding 628 unnecessary visits to the hospital whereas 36 patients, were immediately hospitalized, for receiving acute life-saving interventions.