TRANS-TELEPHONIC ELECTROCARDIOGRAPHIC MONITORING - EXPERIENCE IN INDIA

A centre for trans-telephonic electrocardiographic monitoring (TTEM) w as established at the Escorts Heart Institute in May 1996. We have rev iewed our experience in the first 398 patients. There were 321 males ( 81%) and 77 females (19%); their age range was 1 month to 95 years. Si xty-five per cent of patients were from New Delhi, while the remainder were from other cities in India and abroad. As well as follow-up of p atients after discharge, the system was used for the evaluation of che st pain, palpitation, chronic angina, arrhythmias, and pacemaker impla nts. Out of 664 symptomatic transmissions, 510 (77%) were for cardiac symptoms like chest pain (309), palpitation (90), uneasiness (61), diz ziness (28) and breathlessness (22); the other 154 (23) were for non-c ardiac symptoms like stitch pain and backache (51), typical chest pain (39), weakness and fever (45), and sweating (19). The majority of pat ients with chest pain (84%), palpitation (78%) and dizziness (75%) tra nsmitted their electrocardiograms within one hour of the onset of the symptoms. Out of 664 symptomatic transmissions, 531 required either re assurance or drug-dose adjustment by telephone and 97 were called to t he outpatient department on an elective basis. Immediate hospitalizati on was advised for 36 patients, for acute management of their symptoms . TTEM was useful in avoiding 628 unnecessary visits to the hospital, while 36 patients were immediately hospitalized for acute care.