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Real-time, two-way interaction during ST-segment elevation myocardial infarction management improves door-to-balloon

Gabriel L Sardi1, Joshua P Loh1, Rebecca Torguson1

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Summary

The CodeHeart application (CHap) significantly reduced door-to-balloon times for ST-segment elevation myocardial infarction (STEMI) patients. This novel telecommunication system enhances STEMI care by enabling real-time interaction and potentially reducing false activations.

Keywords:
Door-to-balloon timePercutaneous coronary interventionST-segment elevation myocardial infarctionTelecommunications

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Area of Science:

  • Cardiology
  • Medical Informatics
  • Health Technology

Background:

  • Pre-hospital electrocardiograms are crucial for ST-segment elevation myocardial infarction (STEMI) management.
  • Existing telecommunication systems lack real-time interaction capabilities with initial care providers.
  • A novel, secure telecommunication application (CodeHeart application - CHap) was developed for real-time, two-way voice and video interaction.

Purpose of the Study:

  • To evaluate the impact of the CodeHeart application (CHap) on door-to-balloon (DTB) times in STEMI patients.
  • To determine if CHap improves the efficiency of STEMI care delivery.

Main Methods:

  • Prospective data collection of all STEMI system activations post-CHap implementation.
  • Comparison of consecutive CHap activations against routine activations during the same period.
  • Analysis of door-to-balloon times and first call-to-balloon times.

Main Results:

  • CHap was utilized in 17.7% of 470 STEMI activations.
  • CHap significantly reduced DTB time (103 minutes) compared to standard care (149 minutes, p<0.0001).
  • First call-to-balloon time was also reduced with CHap (70 minutes vs. 92 minutes, p=0.0002).

Conclusions:

  • Real-time interaction via CHap improves door-to-balloon times for STEMI patients.
  • The system shows potential for decreasing false activations, enhancing cost-efficiency.
  • Implementation of two-way telecommunication systems is beneficial for STEMI network management.