Reich C, Frey N, Giannitsis E
Medizinische Klinik III, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.
Herz. 2024 Jun;49(3):190-197. doi: 10.1007/s00059-024-05242-5. Epub 2024 Mar 7.
Digitalization in cardiovascular emergencies is rapidly evolving, analogous to the development in medicine, driven by the increasingly broader availability of digital structures and improved networks, electronic health records and the interconnectivity of systems. The potential use of digital health in patients with acute chest pain starts even in the prehospital phase with the transmission of a digital electrocardiogram (ECG) as well as telemedical support and digital emergency management, which facilitate optimization of the rescue pathways and reduce critical time intervals. The increasing dissemination and acceptance of guideline apps and clinical decision support tools as well as integrated calculators and electronic scores are anticipated to improve guideline adherence, translating into a better quality of treatment and improved outcomes. Implementation of artificial intelligence to support image analysis and also the prediction of coronary artery stenosis requiring interventional treatment or impending cardiovascular events, such as heart attacks or death, have an enormous potential especially as conventional instruments frequently yield suboptimal results; however, there are barriers to the rapid dissemination of corresponding decision aids, such as the regulatory rules related to approval as a medical product, data protection issues and other legal liability aspects, which must be considered.
心血管急症的数字化正迅速发展,类似于医学领域的发展,这是由数字结构日益广泛的可用性、改进的网络、电子健康记录以及系统的互联互通所推动的。数字健康在急性胸痛患者中的潜在应用甚至在院前阶段就已开始,包括数字心电图(ECG)的传输、远程医疗支持和数字应急管理,这些有助于优化救援路径并缩短关键时间间隔。预计指南应用程序、临床决策支持工具以及综合计算器和电子评分的日益普及和接受将提高对指南的依从性,从而带来更高的治疗质量和更好的治疗结果。实施人工智能以支持图像分析以及预测需要介入治疗的冠状动脉狭窄或即将发生的心血管事件,如心脏病发作或死亡,具有巨大潜力,尤其是因为传统手段往往产生不理想的结果;然而,相应决策辅助工具的快速传播存在障碍,如作为医疗产品审批的监管规则、数据保护问题和其他法律责任方面,这些都必须加以考虑。