Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Introduction: The diagnostic accuracies of different electrocardiography (ECG) interpretation methods remain unclear. Therefore, this study aimed to systematically evaluate and compare the diagnostic accuracy of prehospital 12-lead ECG interpretation methods for identifying ST-elevation myocardial infarction (STEMI) and activating cardiac catheterization laboratories (CCLs).
Methods: A comprehensive search was conducted in Medline, Scopus, and CINAHL databases up to August 2024. Two reviewers independently selected studies that assessed the diagnostic accuracy of prehospital 12-lead ECG in real-time STEMI identification and CCL activation. Pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated using bivariate generalized mixed-effects regression models or random-effects meta-analysis as appropriate. The quality of the included studies was assessed using the QUADAS-2 tool.
Results: Thirty-six studies involving 67,168 patients were included. Overall, for STEMI identification, the pooled AUC of ECG was 0.96 (95%CI:0.94-0.98), sensitivity was 80% (95% CI, 69-88%), specificity was 97% (95%CI: 94-98%), and DOR was 114 (95%CI: 59-222). Ambulance clinicians achieved the highest DOR (264; 95%CI: 33-2125), followed by transmission method (136; 95%CI, 59-312) and computer-assisted analysis (78; 95%CI: 33-186). Transmission method demonstrated superior specificity (0.98; 95%CI: 0.94-0.99) and the lowest rates of inappropriate (13.2%; 95% CI: 8.6%-19.2%), and false-positive (11.0%; 95%CI: 6.9%-15.0%) CCL activations.
Conclusion: All prehospital ECG interpretation methods yielded acceptable diagnostic accuracy for STEMI identification; however, transmission offered the greatest specificity and fewer unnecessary CCL activations. Adopting transmission-based strategies, where feasible, and enhancing training and decision support for ambulance clinicians may improve prehospital STEMI detection and resource utilization.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145131 | PMC |
| http://dx.doi.org/10.22037/aaemj.v13i1.2627 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical consequences of smartwatch implementation in a cardiology outpatient clinic.
Dan Med J
August 2025
Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte Hospital.
Introduction: Long-term cardiac monitoring has become more accessible with the advent of consumer-oriented wearable devices. Smartwatches (SWs) hold promise for extended rhythm monitoring owing to their availability and direct electronic health record (EHR) integration. We studied the clinical consequences of SW implementation in patients with palpitations.
View Article and Find Full Text PDFArtificial Intelligence in Adult Congenital Heart Disease: Diagnostic and Therapeutic Applications and Future Directions.
Rev Cardiovasc Med
August 2025
Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, LE3 9QP Leicester, UK.
Adult congenital heart disease (ACHD) constitutes a heterogeneous and expanding patient cohort with distinctive diagnostic and management challenges. Conventional detection methods are ineffective at reflecting lesion heterogeneity and the variability in risk profiles. Artificial intelligence (AI), including machine learning (ML) and deep learning (DL) models, has revolutionized the potential for improving diagnosis, risk stratification, and personalized care across the ACHD spectrum.
View Article and Find Full Text PDFQT Interval and Cardiac Restitution Ratio Complexity in Standardbred Racehorses From Rest to Maximal Effort: Insights Into Arrhythmia Risk.
J Vet Intern Med
September 2025
Department of Population Medicine, Ontario Veterinary College, University of Guelph, Ontario, Canada.
Background: Sudden cardiac death is common in racehorses. Factors associated with the QT interval that could predispose to fatal cardiac arrhythmias are unknown. Cardiac restitution, expressed as a ratio of QT/TQ, has been used in humans to assess arrhythmia risk but has not been described in horses during maximal intensity exercise.
View Article and Find Full Text PDFChallenges encountered by healthcare workers in managing door-to-balloon time of myocardial infarction: A survey.
Int Emerg Nurs
September 2025
Professor, School of Health & Biomedical Sciences, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia. Electronic address:
Background: ST-segment elevation myocardial infarction (STEMI) demands aggressive and rapid medical intervention. Delays in Door-to-balloon time (DTB) of more than 90 min cause progressive damage to the cardiac tissue and require immediate medical intervention, including percutaneous coronary intervention (PCI). Nurses and doctors in STEMI management face several challenges that result in a delay in DTB time.
View Article and Find Full Text PDFPrevalence and Risk Factors of Arrhythmias in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.
Int J Chron Obstruct Pulmon Dis
September 2025
Department of Cardiovascular Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
Background: Cardiac arrhythmias are commonly seen in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but their prevalence, risk factors, and prognostic significance are still not fully understood.
Objective: To estimate the prevalence of arrhythmias in patients with AECOPD, identify related clinical factors, and assess their influence on in-hospital mortality.
Methods: A systematic search of PubMed, Embase, Web of Science, CENTRAL, and Cochrane Reviews was conducted to identify observational studies and randomized controlled trials.