Patients with established coronary artery disease (CAD) were recruited in 11 hospitals and randomized to an intervention (telemedicine system; n=752) or a control group (usual medical care; n=748). On the day before discharge, patients in the intervention group were equipped with a 12-lead event recorder and trained to use the device. Whenever they had symptoms, they could contact the call centre, transmit an ECG (without redialling) and consult a physician. During a 12-month study, 171 patients (23%) in the intervention group contacted the call centre, a total of 269 times. The main reasons for calling were chest pain and radiating pain. Pathological changes were seen in 24% of the transmitted ECGs. Only 23% of the calls were made in the first hour after onset of symptoms and a further 12% in the subsequent hour, suggesting that patients should be encouraged to use ECG transmission at an earlier stage. At follow-up, 157 patients (21%) had had at least one recurrent cardiac event (myocardial infarction, cardiac hospital stay, reascularization). The proportion was significantly higher in telemedicine users (35%) than in non-users (17%), P<0.001. Regardless of utilization, the majority of the intervention patients considered that the telemedicine system was helpful (users=93%, non-users=89%; P=0.095).
Research Areas and Centers
- Research Area: Center for Population Medicine and Public Health (ZBV)