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Updated: Aug 19, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Impact of Prehospital Electrocardiogram on Outcome in Patients With Suspected Acute Coronary Syndrome in Helicopter

Takashi Nakata1, Hiroyuki Ohbe2, Tetsuya Sato2

  • 1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Emergency and Critical Care Medicine, Tohoku University Hospital, Sendai, Japan.

Air Medical Journal
|August 17, 2026
PubMed

Insights

Prehospital electrocardiography (ECG) in helicopter emergency medical services (HEMS) significantly shortens cardiac catheterization times for acute coronary syndrome (ACS) patients. This improves ACS management without increasing mortality, despite slightly longer scene times.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Aviation Medicine

Background:

  • Current guidelines emphasize rapid reperfusion for acute coronary syndrome (ACS), targeting first medical contact-to-percutaneous coronary intervention (PCI) within 120 minutes and door-to-balloon (D2B) within 90 minutes.
  • Prehospital electrocardiography (ECG) in ambulances has demonstrated benefits in reducing mortality and D2B times for ACS patients.
  • The impact of prehospital ECG within helicopter emergency medical services (HEMS) on ACS patient outcomes remains understudied.

Purpose of the Study:

  • To evaluate the effect of prehospital ECG performed by flight physicians in HEMS.
  • To assess the impact on time to cardiac catheterization, patient mortality, and in-flight treatment for ACS patients.
  • To determine the effectiveness of prehospital ECG in the HEMS setting for ACS management.

Main Methods:

  • Retrospective analysis of patients suspected of ACS transported by physician-crewed HEMS.
  • Data sourced from the Japan Society for Aviation Medicine Doctor Helicopter National Case Registry System.
  • Study period: April 2020 to March 2023, including patients who underwent coronary angiography.

Main Results:

  • Prehospital ECG was associated with a significant reduction in time from hospital arrival to cardiac catheterization (-9.1 minutes).
  • A slight increase in time spent at the scene was observed in the prehospital ECG group (+1.09 minutes).
  • Nitrate administration was more frequent in the prehospital ECG group (OR 2.70), while all-cause mortality showed no significant difference.

Conclusions:

  • Prehospital ECG utilization in HEMS is linked to expedited cardiac catheterization for ACS patients.
  • This suggests prehospital ECG can be a valuable tool for optimizing ACS management in HEMS.
  • Further research may explore strategies to mitigate increased scene times while maximizing ECG benefits.
Abstract

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