Advanced practice providers should interpret 12-lead ECGs

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Due to the rapid development of cardiac diagnostic modalities such as imaging techniques, device therapies, invasive procedures and cardiogenomics, many cardiology trainees lack personal interest in clinical electrocardiography (ECG) training. In addition, fewer and fewer practioners are mentoring trainees in this skill. Thus, most ECGs are read by non-cardiologists, including emergency, urgent care and family practice-physicians who do not necessarily have clinical ECG training. Purpose: The purpose of this proposal is to promote the training and certification of Advanced Practice Providers (APPs) to interpret 12-lead ECGs. Rationale. By tradition, as health care tasks increase in complexity, many physician-based tasks are delegated to APPS, especially in the demanding hospital setting. For example, nurses continuously monitor and interpret all bedside ECG arrhythmias and myocardial ischemia. The transition of cardiologist read 12-lead ECGs to APP read 12-lead ECG makes sense in light of the ubiquitous computerization of the ECG which provides high quality waveforms with sophisticated algorithms to help guide in decision making. Despite significant improvements in cardiac technology, the 12-lead ECG remains the classic, non-invasive gold standard for the diagnosis of a myocardial infarction (MI) and it is expected to be interpreted within 10 minutes of chest pain onset. Conclusion: Cardiologists have moved on to utilize new technology for secondary and tertiary evaluations, 12-lead ECGs are the first line diagnostic tool in diagnosis of MI. By training and certifying APPs in ECG interpretation, higher quality, rapid initial diagnosis will be made without delays.