Session S33.1

Pre-Hospital Wireless Transmission of STEMI Electrocardiograms Persistently Reduces Door-to-Percutaneous Coronary Intervention Times

GL Adams*, BA Lee, K Underhill, C Maynard, J Patterson, N Yellin,
DR Rosenfelder, GEL Lamar, S Doroh, PT Campbell, GS Wagner

Duke University
Durham, NC, USA

Objective: The American College of Cardiology/American Heart Association guideline for PCI door-to-balloon time (<90 minutes) in STEMI patients is a goal infrequently accomplished. This study tested the hypothesis that: (1) ECG transmission at the pilot site produces reperfusion times faster than those at the TIME-MC control sites awaiting transmission capability and (2) reduction in time to PCI at the pilot site will be maintained and increased use of EMS attained.
Methods: This study prospectively enrolled 252 STEMI patients transported by Emergency Medical Services (EMS) over a 1.5 year period. The study was divided into two groups: (1) a pre-intervention group (TIME-MC), and (2) an intervention follow-up group (TIME-NE). A comparison was made between EMS transported patients during the TIME-NE follow-up phase to (a) TIME-NE intervention phase EMS transported patients, and (b) TIME-MC pre-intervention phase EMS transported patients.
Results: During the TIME-NE intervention phase (2003 to 2005), 43 patients were enrolled and during the follow up phase (2005-2006), 53 patients were enrolled. During the TIME-MC pre-intervention phase (2005-2006), 199 patients were enrolled. The median door-to-reperfusion time for patients during the TIME-NE follow up period was 64 minutes, significantly shorter than the pre-intervention TIME-MC times and without significant change compared to the intervention TIME-NE period. Also, there was a trend toward increased EMS use comparing the TIME-NE intervention period to the follow up period (p=0.047).
Conclusion: A pre-hospital wireless ECG transmission system implemented by NorthEast Medical center continues to maintain faster door-to-reperfusion times than those recommended by the ACC/AHA guidelines and the pre-intervention sites in the TIME-MC study.

(Abstract Control Number: 21)