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[Transmission of the electrocardiogram via telephone. Analysis of 10 years' experience]
P Bartůnĕk1, K Gorican, J Zapletalová
1IV interní klinika I. LF UK a VFN, Praha.
Insights
Telephone electrocardiogram transmission effectively detects arrhythmias, especially in emergency situations. This method enhances diagnostic capabilities for sporadic arrhythmias and improves patient management.
Area of Science:
- Cardiology
- Medical Technology
Context:
- Impaired cardiac rhythm diagnosis is a growing concern for cardiologists.
- Diagnostic challenges in detecting and identifying arrhythmias persist.
- The CAST study significantly altered therapeutic strategies for cardiac rhythm disorders.
Purpose:
- To evaluate the advantages and utility of telephone electrocardiogram (ECG) transmission.
- To assess its role within a comprehensive diagnostic framework for cardiac arrhythmias.
Summary:
- A study involving 251 patients (186 men, 65 women, average age 51.7) analyzed 3,727 telephone ECGs using the TESLAR system.
- The method demonstrated high arrhythmia detection rates in emergency calls (88.5%) compared to normal calls (10.6%).
- Telephone ECGs offer advantages over Holter monitoring, including flexible time for recording and higher diagnostic yield.
Impact:
- Confirms telephone ECG transmission extends diagnostic capabilities for short-term, symptomatic, and sporadic arrhythmias.
- Facilitates the management of at-risk patients and those with permanent pacemakers.
- Improves the strategic approach to antiarrhythmic treatment and patient care.
Background:
The problem of impaired cardiac rhythm is in recent years in the foreground of the interest of cardiologists. This was influenced not only by the conclusions of the CAST study which changed the therapeutic pattern used for some years but above all the diagnostic pitfalls of impaired rhythm as regards detection and identification. The objective of the present study was to provide evidence of the advantages and usefulness of the method of telephone transmission of the electrocardiogram within the complex of other diagnostic procedures.
Methods And Results:
The group was formed by 251 patients, incl. 186 men and 65 women, average age 51.7 years (range 19-85 years). The transmission of the ECG by phone was implemented by the system TESLAR (VUIS-CVUT) which comprises recording units and a terminal with a graphic outlet. A total of 3,727 electrocardiographic tracings were assembled. During their analysis the arithmetic mean was used as the characteristic of the position of the group or groups on the scale, the error of the mean expressing the ratio of the standard deviation to the number of cases. In nominal variables most frequently percentage expression was used, frequently with a confidence interval obtained from tables. Evidence of the usefulness of the method is the high rate of detected arrhythmias within emergency calls (88.5%), as compared with normal calls (10.6%) where the yield is close to that of Holter monitoring, however, with the advantage of time ad libitum and thus also a higher yield.
Conclusions:
The presentation of long-term experience with electrocardiograms by telephone confirms unequivocally the assumption that the method extends existing diagnostic possibilities in short-term, symptomatic, but sporadic arrhythmias, that it makes possible dispensarization of risk patients as well as patients with permanent pacemakers and that it improves the tactics of antiarrhythmic treatment.