medicina54巻11号

2017年10月発行

特集 自信をもって対応する—虚血性心疾患 プレホスピタル治療への取り組み

onset to balloon time短縮のための心電図伝送システム

著者： 藤田英雄¹

所属機関： ¹自治医科大学附属さいたま医療センター循環器内科

ページ範囲：P.1834 - P.1837

Point
◎Door to balloon time（DTBT）は10分の短縮で死亡リスク8％相当の低減効果をもつ．
◎STEMI予後改善のためにプレホスピタル心電図が有効である．
◎モバイルICTを応用したクラウド心電図システムが開発された．
◎プレホスピタル領域の変革によりonset to balloon time（OTBT）短縮も予後改善のための標的となる．

参考文献

1）Nallamothu BK, et al：Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time；A retrospective study. Lancet 385：1114-1122, 2015

2）Shiomi H, et al：Association of onset to balloon and door to balloon time with long term clinical outcome in patients with ST elevation acute myocardial infarction having primary percutaneous coronary intervention；Observational study. BMJ 344：e3257, 2012

3）Le May MR, et al：A citywide protocol for primary PCI in ST-segment elevation myocardial infarction. N Engl J Med 358：231-240, 2008

4）Task Force on the management of ST-segment elevation acute myocardial infarction of the ESC, Steg PG, et al：ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 33：2569-2619, 2012

5）American College of Emergency Physicians, Society for Cardiovascular Angiography and Interventions, Interventions, O'Gara PT, et al：2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction；A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 61：e78-140, 2013

6）Bagai A, et al：Emergency department bypass for ST-segment-elevation myocardial infarction patients identified with a prehospital electrocardiogram；A report from the American Heart Association Mission；Lifeline program. Circulation 128：352-359, 2013

7）Kawakami S, et al：Time to reperfusion in ST-segment elevation myocardial infarction patients with vs. without pre-hospital mobile telemedicine 12-lead electrocardiogram transmission. Circ J 80：1624-1633, 2016

8）Takeuchi I, et al：Impact of doctor car with mobile cloud ECG in reducing door-to-balloon time of Japanese ST-elevation myocardial infarction patients. Int Heart J 56：170-173, 2015

9）Takeuchi I, et al：Initial experience of mobile cloud ECG system contributing to the shortening of door to balloon time in an acute myocardial infarction patient. Int Heart J 54：45-47, 2013

10）株式会社メハーゲン：クラウド型12誘導心電図伝送システム2017　http://www.medi-aid.jp/products/twelve/（2017年6月閲覧）

11）株式会社NTTドコモ　https://www.docomo.biz/html/service/electrocardiogram/（2017年6月閲覧）