[Electrocardiographic diagnosis of rural emergencies, by applying a tele-ECG recording and analysis system]

To identify emergencies in rural dwellers during electrocardiographic examination using a tele-electrogram (ECG) analysis (Easy ECG) system.

The easy ECG system connected 4 therapeutic-and-prophylactic institutions of a rural area and the town of Uryupinsk with the Research Institute of Cardiology, Russian Cardiology Research-and-Production Complex (Moscow). A total of 1,027 ECGs were recorded and analyzed in March 25, 2013 to November 11, 2013.

Based on complaints, data of physical examinations, and results of ECG analysis, the investigators detected 188 (18.3%) emergency cases; 39 (3.8%) rural dwellers were first diagnosed as having emergencies. There were new found cases of acute coronary syndrome (n = 2), focal cicatricial changes (n = 11), including focal injury in the presence of left bundle-branch block (LBBB) (n = 2), and ischemic cardiomyopathy (n = 1) due to prior extensive myocardial infarction (as high as 28.2%). The frequent finding was intraventricular blocks (46.1%), including LBBB (n = 4) and right bundle-branch block (n = 1) (as high as 12.8%); the signs of left ventricular hypertrophy were encountered in 12 cases, as well as in 2 cases in the presence of LBBB (as high as 38.5%).

The findings show the value of bedside recording of ECG with its remote analysis in the absence of special diagnostic services. Each of the detected electrocardiographic syndromes is a risk factor of cardiac death.