Rationale, development, and implementation of the Electrocardiographic Methods for the Prehospital Identification of Non-ST Elevation Myocardial Infarction Events (EMPIRE)

Journal of Electrocardiology
Salah S Al-ZaitiClifton W Callaway

Abstract

The serum rise of cardiac troponin remains the gold standard for diagnosing non-ST elevation (NSTE) myocardial infarction (MI) despite its delayed response. Novel methods for real-time detection of NSTEMI would result in more immediate initiation of definitive medical therapy and faster transport to facilities that can provide specialized cardiac care. EMPIRE is an ongoing prospective, observational cohort study designed to quantify the magnitude of ischemia-induced repolarization dispersion for the early detection of NSTEMI. In this ongoing study, prehospital ECG data is gathered from patients who call 9-1-1 with a chief complaint of non-traumatic chest pain. This data is then analyzed using the principal component analysis (PCA) technique of 12-lead ECGs to fully characterize the spatial and temporal qualities of STT waveforms. Between May and December of 2013, Pittsburgh EMS obtained and transmitted 351 prehospital ECGs of the 1149 patients with chest pain-related emergency dispatches transported to participating hospitals. After excluding those with poor ECG signal (n=40, 11%) and those with pacing or LBBB (n=50, 14%), there were 261 eligible patients (age 57±16years, 45% female, 45% Black). In this preliminary sample, ther...Continue Reading

References

Apr 6, 2013·Cardiology Journal·Gjin NdrepepaAdnan Kastrati
Jul 19, 2013·Journal of Electrocardiology·Itamar Birnbaum, Yochai Birnbaum
Jan 10, 2014·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Micah OwnbeyChristian Martin-Gill
Jan 30, 2014·Medical & Biological Engineering & Computing·Pedro David AriniPablo Laguna
Jun 24, 2014·American Heart Journal·Mohamad KenaanUNKNOWN Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)
Jul 22, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Rodney De PalmaThomas Cuisset

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Citations

Oct 28, 2017·Biological Research for Nursing·Salah Al-ZaitiFadi Khraim
Feb 25, 2018·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Ivo StrebelTobias Reichlin
Aug 2, 2019·Emergency Medicine Journal : EMJ·Ziad FaramandSalah S Al-Zaiti
Jun 20, 2017·Medical & Biological Engineering & Computing·Salah Al-ZaitiRobert Lux
Jan 19, 2020·BMC Cardiovascular Disorders·Michał CzaplaPiotr Karniej
Sep 19, 2020·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Ziad FaramandSalah Al-Zaiti
Oct 13, 2020·The American Journal of Emergency Medicine·Ziad FaramandSalah Al-Zaiti

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