Reifart N, Weil H J, Göhring S, Dietl J
Herzzentrum und Rotes Kreuz Krankenhaus, Frankfurt am Main.
Dtsch Med Wochenschr. 1997 Sep 19;122(38):1137-40. doi: 10.1055/s-2008-1047739.
Different from the situation in the USA, Canada, Israel, Italy and Great Britain transmission of electrocardiograms (ECG) by telephone plays an unimportant part in Germany because existing technology is at best adequate for the diagnosis of arrhythmias. A new simple system, the size of a mobile phone (P12, Aerotel, Israel), was tested: for the first time in Europe it allows patients themselves to obtain a 12-lead ECG and transmit it via any telephone to a centre for analysis. This system was evaluated for its reliability when used by lay persons.
Qualitative and quantitative parameters of a conventional 12-lead ECG obtained in 217 patients (86 women, 131 men) were compared with those of 12-lead ECGs recorded and stored by lay persons, transmitted via telephone to a computer and then printed out.
All ECGs transmitted with the P12 were analysable: quality was good or very good in 86%. Heart rate, transmission time and the various durations agreed with the conventional leads, while P12 underregistered amplitudes by about 15%. This difference was correctable by a constant or by adjusting the ECG machine. Atrial fibrillation (in eight of eight cases), infarct changes (40 of 40), ST elevations or depressions (15 of 15) and T negativities (80 of 82) were also reliably recognized.
The described method proved simple and reliable. Clinically significant information in the ECG can be transmitted within minutes and with high diagnostic reliability to a central station via any telephone. P12 is thus suitable for self-recording of ECGs by patients with potentially dangerous cardiac conditions. However a centre with cardiologically trained personnel should be available where telephone transmission of the ECGs and dialogue with the patients is possible around the clock.
与美国、加拿大、以色列、意大利和英国的情况不同,在德国,通过电话传输心电图(ECG)的作用不大,因为现有技术充其量仅足以诊断心律失常。对一种新型简易系统(手机大小,P12,以色列Aerotel公司)进行了测试:在欧洲首次实现患者可自行获取12导联心电图,并通过任何电话将其传输至分析中心。对该系统在外行人员使用时的可靠性进行了评估。
将217例患者(86例女性,131例男性)常规12导联心电图的定性和定量参数,与外行人员记录并存储、通过电话传输至计算机然后打印出来的12导联心电图的参数进行比较。
所有通过P12传输的心电图均可分析:86%的质量良好或非常好。心率、传输时间和各种间期与常规导联一致,而P12记录的振幅约低15%。通过常数或调整心电图机可校正此差异。心房颤动(8例中的8例)、梗死改变(40例中的40例)、ST段抬高或压低(15例中的15例)以及T波倒置(82例中的80例)也均能可靠识别。
所述方法简单可靠。心电图中的临床重要信息可在数分钟内通过任何电话以高诊断可靠性传输至中心站。因此,P12适用于有潜在危险心脏疾病患者自行记录心电图。然而,应设有具备心脏科专业知识人员的中心,以便能随时进行心电图的电话传输并与患者进行沟通。