Paramedic transtelephonic communication to cardiologist of clinical and electrocardiographic assessment for rapid reperfusion of ST-elevation myocardial infarction

J Electrocardiol. 2007 Jul;40(3):265-70. doi: 10.1016/j.jelectrocard.2006.11.006. Epub 2007 Feb 8.


Background/purpose: We tested the hypothesis that paramedic recognition of ST-elevation myocardial infarction (STEMI) and cardiologist activation of the cardiac catheterization laboratory without transmission of the electrocardiogram reduces door-to-balloon times.

Methods: We studied a consecutive series of patients suspected to have STEMI who were taken to the cardiac catheterization laboratory in the 6-month period before hotline implementation (historical controls) and during the first year of hotline use (intervention group, hotline; emergency medical service patients without hotline, concurrent controls).

Results: Emergency medical services activated the hotline 47 times, and 25 patients were subsequently taken to the catheterization laboratory. Patients who received PCI involving hotline use (n = 20) had significantly shorter door-to-balloon times (58 minutes; 25th-75th percentile, 52-73 minutes) than historical controls (n = 15) (112 minutes; 25th-75th percentile, 81-137; P < .0001) and concurrent controls (n = 15) (92 minutes; 25th-75th percentile, 76-112; P = .019).

Conclusions: Paramedic transtelephonic communication to cardiologist of clinical and electrocardiogram assessment resulted in a 54-minute reduction in door-to-balloon time for patients with STEMI.

Publication types

  • Clinical Trial

MeSH terms

  • Cardiology / methods
  • Cell Phone
  • Coronary Artery Bypass / methods
  • Electrocardiography / methods*
  • Emergency Medical Services / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / surgery*
  • Myocardial Reperfusion / methods*
  • North Carolina
  • Quality Assurance, Health Care / methods
  • Remote Consultation / methods*
  • Telemedicine / methods*
  • Time Factors
  • Time and Motion Studies
  • Treatment Outcome