Electrocardiogram in Field Can Benefit Heart Attack Response

'Door-to-balloon' times faster than if electrocardiogram is taken in the hospital
By A. Agrawal, PhD
HealthDay Reporter

FRIDAY, Jan. 22 (HealthDay News) -- Patients suspected of having a heart attack have a shorter door-to-balloon (D2B) time and are able to start reperfusion therapy faster if they have an electrocardiogram (ECG) taken in the field by emergency response personnel rather than in the hospital, according to a study in the Feb. 1 issue of Catheterization and Cardiovascular Interventions.

Anjani Rao, M.D., of Providence Hospital and Medical Center in Southfield, Mich., and colleagues compared D2B times in 108 patients with chest pain (suggestive of ST-segment elevation myocardial infarction [STEMI]), where a 12-lead ECG was obtained by emergency response personnel in the field and immediately transmitted to the emergency room (ER) physician, and in 241 patients with similar symptoms who had an ECG in the hospital.

The researchers found that the mean D2B time was significantly shorter for patients who had a prehospital ECG (60.2 versus 90.5 minutes). For patients who had an in-hospital ECG, the mean D2B time was significantly shorter for patients who presented during working hours compared with off-hours (75 versus 98 minutes). In contrast, the reduction in D2B time was independent of the time of presentation for the prehospital ECG group. There were no significant differences in mortality or length of hospital stay.

"Utilizing the prehospital ECG as a tool to bypass ER triage significantly decreases D2B times in patients with STEMI," the authors write. "Our results re-emphasize the importance of early activation of the cardiac catheterization laboratory in order to improve time-to-reperfusion in patients with STEMI."

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