Schwaab Bernhard, Katalinic Alexander, Richardt Gert, Kurowski Volkhard, Krüger Dietmar, Mortensen Kai, Lorenz Eduard, Sheikhzadeh Abdolhamid
Department of Cardiology and Cardiovascular Rehabilitation, Curschmann Klinik, Timmendorfer Strand, Germany.
J Telemed Telecare. 2006;12(6):315-8. doi: 10.1258/135763306778558204.
A 12-lead electrocardiogram (ECG) recorded in patients with acute coronary syndrome (ACS) was transmitted to a call centre via telephone (tele-ECG). In 120 patients (mean age 64 years) referred to hospitals because of ACS, a standard 12-lead ECG and a tele-ECG recorded at the same time were compared by two cardiologists and one internist independently and blindly. Conduction times exhibited very good agreement between standard and tele-ECG with reliability coefficients (R) of 0.91, 0.86 and 0.89 for the PQ-, QRS- and QT interval, respectively. Rhythm analysis was correct in 99% of the cases. Negative T waves, ST-segment elevation and depression were detected with very high agreement in the tele-ECG exhibiting kappa (kappa) coefficients between 0.75 and 0.96. The correct ECG diagnosis of ST-elevation myocardial infarction (STEMI) was possible with excellent agreement between standard and tele-ECG, showing kappa coefficients of 0.96, 0.99 and 0.99, respectively, for three investigators. The 12-lead tele-ECG recorder proved accurate for the detection of acute STEMI.
急性冠状动脉综合征（ACS）患者记录的12导联心电图（ECG）通过电话传输至呼叫中心（远程心电图）。在120例因ACS转诊至医院的患者（平均年龄64岁）中，两名心脏病专家和一名内科医生独立且盲法地比较了同时记录的标准12导联心电图和远程心电图。传导时间在标准心电图和远程心电图之间显示出非常好的一致性，PQ、QRS和QT间期的可靠性系数（R）分别为0.91、0.86和0.89。99%的病例节律分析正确。在远程心电图中，负向T波、ST段抬高和压低的检测一致性非常高，kappa系数在0.75至0.96之间。标准心电图和远程心电图之间对ST段抬高型心肌梗死（STEMI）的心电图诊断一致性极佳，三名研究者的kappa系数分别为0.96、0.99和0.99。12导联远程心电图记录仪被证明对急性STEMI的检测准确。
