Abstract 27: Novel Use of Wireless 12-Lead Electrocardiogram Transmission in a Prehospital Setting

Abstract

Introduction The AHA/ACC guidelines recommend pre-hospital 12-lead electrocardiogram (ECG) transmission to a percutaneous coronary intervention (PCI) hospital to facilitate the care of patients with acute coronary syndrome. We created a handheld wireless 12-lead ECG transmission system called Fujiyama involving Cardiospy® Mobile, a handheld 12-lead ECG recording device. Fujiyama functions by transmitting the ECG from Cardiospy® Mobile to a smartphone through Bluetooth wireless technology, converting the ECG to MFER(Medical Waveform Format Encoding Rule)/JPEG, and sending it to a designated email address using ubiquitous and standard network. Hypothesis We predicted that our smaller device will be equally efficacious in transmitting accurate data as the current portable ECG recording device used in the healthcare industry. Methods We recorded and transmitted 12-lead ECGs using our device from a moving vehicle (simulating an ambulance), and investigated the influences of road turbulence, body movements, fast driving, as well as transmission time and accuracy by comparing ECGs recorded in a hospital setting. Furthermore, after approval from the institutional review board, the device was tested on 24 actual patients (4 emergency room, 5 clinic, 4 home hemodialysis, 11 visiting nurse care) transmitting ECGs to the attending cardiologist of a PCI hospital. Results There were no significant ECG differences found between sent and received ECGs, and vehicle speed did not affect the baseline ECG. Body movement, blood pressure measurement and cardiac compression caused the baseline to wander to some extent, but did not affect ECG interpretation. The transmission time of a 250-350 KB file was 7-95 s (median 23 s), short enough for emergency settings. Transmission rate of the 24 ECGs was 100 %, and only one had significant interference from appliances and peripheral equipment. Conclusions As far as we know, this system is the first wireless 12-lead ECG recording and transfer device in this weight (150 g, including batteries) and size category (70 × 38 × 125 mm). In conclusion, successful implementation of this system may improve the communication and care of patients with acute coronary syndrome in various settings, including emergency pre-hospital care.