INTERNET ECG IN THE DIFFERENTIAL DIAGNOSIS OF CARDIALGIA AT THE PREHOSPITAL STAGE

Abstract

Late hospitalization of patients with acute myocardial infarction (AMI) is an important cause of mortality and disability. The main reasons are a high prevalence of atypical clinical forms and especially the organization of ECG services of urban health centers - waiting time ECG recording reaches 10-14 days. The solution to this problem, we see the introduction of Internet-ECG in ambulatory health care work. For testing complex «Сardiometr» (SPb) was chosen. Materials and methods: The study held on the City polyclinics N 37 St. Petersburg. To verify the automatic conclusion of ECG was performed 8863 record in the office of functional diagnostics. In addition, within 3 years of portable ECG devices used by district doctors for ECG at home for patients with chest pain. The results of the automatic conclusion matched with the expert opinion of the doctor. Results: Automatic analysis allows a high degree of certainty to detect cardiac arrhythmia (fibrillation and atrial flutter, supraventricular and ventricular arrhythmias) and conduction disturbances. Several match less automatic and clinical findings on border violations repolarization processes and identifying unexpressed forms of left ventricular hypertrophy. There has also been a high percentage of matches automatically and medical opinions on the stage and location of focal ECG changes. Using Internet ECG district doctors when visiting patients with cardialgia possible to significantly reduce the proportion of patients hospitalized in the late periods (over 12 hours) from 28% to 19% (p=0.01). Conclusion: Online ECG system with high sensitivity and specificity in the detection of significant arrhythmias, focal ECG changes can significantly reduce the time to take a decision on the need for emergency hospitalization, which increases the proportion of patients admitted to hospital in the early hours of the appearance of manifestations of acute coronary syndrome.