Very Rapid Treatment of ST-Segment–Elevation Myocardial Infarction

Abstract

P rehospital ECG (PH-ECG) has been identified as a strategy to help reduce door-to-balloon (D2B) time during emergency treatment with percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI). 1 National Registry of Myocardial Infarction data from 2000 -2002 suggest utilization rates of PH-ECG of 10%. 2 More recent analysis of data from the National Cardiovascular Data Registry-Acute Coronary Treatment and Intervention Outcomes Network Registry of 7000 patients with acute coronary syndrome transported by emergency medical services (EMS) during 2007 found PH-ECG utilization rates of 27.4%. 3 Among this cohort, D2B times were significantly shorter than the cohort of patients without PH-ECG, and there was a trend toward lower in-hospital mortality.