Establishment of a Digital Tele-Electrocardiographic System in southern Brazil [Abstract in English]

Introduction: A lack of medical specialists in remote areas can delay the diagnosis and the management of diseases. A pioneer Tele-ECG Digital System, DES, was established in Brazil to overcome this situation. Method: DES allows electronic data transmission to and interpretation by a remote cardiologist. Hospitals in Sao Lourenco do Sul, and an outpatient unit in Turucu, both in RS state employed the DES, which includes a digital ECG machine, standard computers, a modem connection, internet facilities, telecommunication software and fixed or mobile phones. Results: A total of 1063 tele-ECGs were performed in the three locations in 1 year: 622 via online and 441 via ehealth. The transmission time was 8.1 min for the online and up to 24h and e-health tele-ECGs. The results showed that 71.2% (443 out of 622) of the online tele-ECGs presented important ECGs alterations, including 66 (14.9%) ECGs with acute signs of myocardial ischemia and 39 ECGs (8.8%) with S-T elevation myocardial infarction. Conclusion: The low cost of DES make it appropriate for small cities and rural areas of developing countries. DES has promoted a significant improvement in the acute management of patients in remote areas, with a consequent decrease in the morbidity and mortality rates from cardiovascular diseases. KEY WORDS: TELEMEDICINE; ELECTROCARDIOGRAPHY; HEART DISEASES/diagnosis; TELECOMMUNICATIONS; INTERNET; EMERGENCIES.