Implementation of international transtelephonic ECG platform for patients with ischemic heart disease

Remigijus Žaliūnas,Rimantas Benetis,Alfonsas Vainoras,Rimvydas Šlapikas,Giedrius Vanagas

doi:10.3390/medicina45020014

Abstract

Ischemic heart disease in European countries over decades causes up to 55% of all cases of sudden death and also has a high rate of mortality, morbidity, and hospital admission. Patients with such chronic diseases also require intensive home care facilities from community nurses. The aim was to establish international multilingual platform for transtelephonic ECG system as an alternative solution for home care and assess its performance. METHODS. During this pilot study, the international toll-free line between Lithuania and Germany was established, and practical applicability of the tele-ECG device was tested. Transtelephonic ECG system was implemented between Telemedicine Center in Bad Segeberg (Bad Segeberg Clinic, Germany), the Call Center in Kaunas at the Hospital of Kaunas University of Medicine, and a patient residence. RESULTS. Over a 6-month follow-up period, 34 patients were recruited. Following the ECG transmission, 86 teleconsultations were done. During the study, a total of 329 ECGs were sent by the patients; out of them, 14 ECGs were with clinical changes. Technical problems due to insufficient patient training, telecommunication systems, acoustic data transmission, and device itself were reported. Up to 23% of ECGs sent by patients were unreadable and not applicable for further clinical analysis. CONCLUSIONS. Our study showed the potential of telemedicine facilities to overcome the problems of access that makes the technique so potentially useful, but for telemonitoring application at patient homes in a wider population, it needs to be improved in terms of technical performance, transmission and analysis automatization.

Highlights

Our study showed the potential of telemedicine facilities to overcome the problems of access that makes the technique so potentially useful, but for telemonitoring application at patient homes in a wider population, it needs to be improved in terms of technical performance, transmission and analysis automatization
Ischemic heart disease (IHD) in European countries over decades has been a common cause of sudden death and has a high rate of mortality, morbidity, and hospital admission and requires long and intensive hospital care [1, 2]
Transtelephonic ECG system was implemented among Telemedicine Center in Bad Segeberg (Bad Segeberg Clinic, Germany), the Call Center in Kaunas at the Hospital of Kaunas University of Medicine, and a patient residence

Summary

Introduction

Ischemic heart disease (IHD) in European countries over decades has been a common cause of sudden death (up to 55% of all cases) and has a high rate of mortality, morbidity, and hospital admission and requires long and intensive hospital care [1, 2]. The first idea of transtelephonic transmissions of electrocardiograms (ECGs), ballistocardiograms (BCGs), and electroencephalograms (EEGs) in the former Soviet Union was developed by Prof. Zigmas Januškevičius and implemented in 1962, when transmissions from Kaunas to Moscow were performed [3]. This was the first telemedicine service trial in the former Soviet Union. Only in late 1980s, tele-ECG screening program using Hewlett Packard system was initiated, aiming to transmit ECGs from rural areas to Kaunas University of Medicine for further analysis. Later telecardiology services were used during the Olympic Games in Sydney in 2000 for remote monitoring of the heart function and reaction to the physical load as well as for the analysis of acclimatization processes and for efficient recovery of cardiovascular system after competitions

Methods

Results

Conclusion