Door-to-ECG time in patients with chest pain presenting to the ED

Am J Emerg Med. 2006 Jan;24(1):1-7. doi: 10.1016/j.ajem.2005.05.016.


Objective: To describe time to electrocardiogram (ECG) acquisition, identify factors associated with timely acquisition, and evaluate the influence of time to ECG on adverse clinical outcomes.

Methods: We measured the door-to-ECG time for emergency department patients enrolled in prospective chest pain registry. Clinical outcomes were defined as occurrence of myocardial infarction or death within 30 days of the visit.

Results: Among patients with acute coronary syndrome (ACS), 34% and 40.9% of patients with non-ST-elevation ACS and ST-elevation myocardial infarction (STEMI), respectively, had an ECG performed within 10 minutes of arrival. A delay in ECG acquisition was only associated with an increase risk of clinical outcomes in patients with STEMI at 30 days (odds ratio, 3.95; 95% confidence interval, 1.06-14.72; P = .04).

Conclusion: Approximately one third of patients with ACS received an ECG within 10 minutes. A prolonged door-to-ECG time was associated with an increased risk of clinical outcomes only in patients with STEMI.

MeSH terms

  • Adult
  • Aged
  • Angina, Unstable / complications
  • Angina, Unstable / diagnosis*
  • Angina, Unstable / therapy
  • Chest Pain / etiology*
  • Electrocardiography*
  • Emergency Service, Hospital*
  • Female
  • Follow-Up Studies
  • Guideline Adherence
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / therapy
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Time Factors