Centenary of tele-electrocardiography and telephonocardiography - where are we today?

Telecardiology applications can be categorized as pre-hospital, in-hospital and post-hospital. The major purpose of pre-hospital 12-lead electrocardiographic diagnosis is the early detection of acute myocardial infarction with ST-segment elevation and the communication of that information to the receiving emergency physician before the arrival of the patient. In-hospital telecardiology is used between small hospitals in rural regions and main hospitals. Telemedicine here has the potential to improve access to echocardiography diagnoses in the intensive care unit, emergency room and newborn nursery. In some centres, urgent echocardiography is performed during weekends, evenings and overnight to assess ventricular function, ischaemia, pericardial effusion, valvular disease and heart donor status. Post-hospital applications include teleconsulting between GPs and specialists, home telenursing for chronic cardiac diseases and the diagnosis of arrhythmias. Telecardiology is one of the fastest-growing fields in telemedicine. There is already a significant quantity of published clinical data, with some randomized multi-centre trials to answer the most important questions definitively. Telecardiology in some fields such as emergency and chronic care undoubtedly improves the quality of health care and helps to contain rising costs. Telecardiology has yet to reach maturity, but the evidence to date indicates that it has made a good start.