{"id":"6b1cdeb1a6fe","type":"article","url":"https://hartvaat.nl/2019/10/22/implanteerbare-monitor-voor-snellere-behandeling-bij-acs/","title":"Implanteerbare monitor voor snellere behandeling bij ACS","title_en":"Implanted Monitor Alerting to Reduce Treatment Delay in Patients With Acute Coronary Syndrome Events.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.07.084","source_url":"https://doi.org/10.1016/j.jacc.2019.07.084","authors":["David R Holmes","Mitchell W Krucoff","Chris Mullin","Ghiath Mikdadi","Dale Presser","David Wohns","Andrew Kaplan","Allen Ciuffo","Arthur L Eberly","Bruce Iteld","David R Fischell","Tim Fischell","David Keenan","M Sasha John","C Michael Gibson"],"significance":6,"published":"2019-10-22","source_date":"2019-10-22","image":"","kennis":[],"congress":"","summary_en":"This study tested whether an implanted cardiac monitor with automated alerting during ACS events reduces treatment delay, exploring technology-enabled earlier presentation for acute coronary syndromes.","created":"2026-07-03T10:28:13Z","updated":"2026-07-03T13:27:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar een geïmplanteerde monitor die alarmeert bij ACS-events voor snellere behandeling.","abstract_original":"BACKGROUND: Increased pre-hospital delay during acute coronary syndrome (ACS) events contributes to worse outcome. OBJECTIVES: The purpose of this study was to assess the effectiveness of an implanted cardiac monitor with real-time alarms for abnormal ST-segment shifts to reduce pre-hospital delay during ACS events. METHODS: In the ALERTS (AngeLmed Early Recognition and Treatment of STEMI) pivotal study, subjects at high risk for recurrent ACS events (n = 907) were randomized to control (Alarms OFF) or treatment groups for 6 months, after which alarms were activated in all subjects (Alarms ON). Emergency department (ED) visits with standard-of-care cardiac test results were independently adjudicated as true- or false-positive ACS events. Alarm-to-door (A2D) and symptom-to-door (S2D) times were calculated for true-positive ACS ED visits triggered by 3 possible prompts: alarm only, alarms + symptoms, or symptoms only. RESULTS: The Alarms ON group showed reduced delays, with 55% (95% confidence interval [CI]: 46% to 63%) of ED visits for ACS events <2 h compared with 10% (95% CI: 2% to 27%) in the Alarms OFF group (p < 0.0001). Results were similar when restricted to myocardial infarction (MI) events. Median pre-hospital delay for MI was 12.7 h for Alarms OFF and 1.6 h in Alarms ON subjects (p < 0.0089). Median A2D delay was 1.4 h for asymptomatic MI. Median S2D delay for symptoms-only MI (no alarm) in Alarms ON was 4.3 h. CONCLUSIONS: Intracardiac monitoring with real-time alarms for ST-segment shift that exceeds a subject's self-normative ischemia threshold level significantly reduced the proportion of pre-hospital delays >2 h for ACS events, including asymptomatic MI, compared with symptoms-only ED visits in Alarms OFF. (AngeLmed for Early Recognition and Treatment of STEMI [ALERTS]; NCT00781118)."}