Overview

Telecardiology is the process wherein a patient's electrical activity results such as ECG and other diagnostic results   like Echocardiogram, Cardiac CT scan, Cardiac MRI scan, etc., can be transmitted and interpreted through telephone or over the internet, facilitating proper diagnosis. Modalities such as Echocardiogram, ECG, Cardiac CT, Cardiac MRI, Carotid Doppler, Stress Echocardiogram, Cardiac Nuclear Scans, Stress Test (TMT), Holter Monitor, Event Monitor, and Second
Opinion for Coronary Angiograms are included under Telecardiology services.

Telemedicine can play a huge role in care delivered by primary care physicians . One of the oldest known telecardiology systems for teletransmissions of ECGs was established in Gwalior, India. The ECG was converted to sound waves with a frequency varying from 500 Hz to 2500 Hz with 1500 Hz at baseline. This system was also used to monitor patients with pacemakers in remote areas. In Pakistan three pilot projects in telemedicine, initiated by the Ministry of IT & Telecom, were linked via the Pak Sat-I communications satellite, and four districts were linked with another hub. A 312 Kb link was also established with remote sites and 1 Mbit/s bandwidth was provided at each hub. These remote sites were
connected and on average of 1,500 patients being treated per month per hub.

The Telecardiology Framework:

The telemedicine framework consists of three participant sites (see Fig.) including the physician at the point-of-care, the specialized cardiologist and the remote information server. At the point of care, a physician acquires the ECG and other relevant information during the clinical intervention using a mobile device and sends it to the information server. Then the information is processed and a results report is automatically produced and stored on the server. Finally, the specialist connects to the information server and gets the results to be analyzed and used in the patient diagnosis.


Figure-1
A Mobile platform:
 
A sample mobile platform in Telecardiology is essentially a wearable device that would be distributed among patients in order to offer continuous monitoring of the patients' vital signs It is composed of a customized sensor board providing connections to a 3-Lead ECG monitoring system, which is housed on a commercially available TelosB sensor mote. While the sensor board gathers useful patient ECG data, the sensor mote provides limited processing capabilities and more importantly wireless communication for transmitting the signals back to the workstation for feature extraction.
  • The TelosB mote is also sometimes referred to as the Tmote Sky, is an ultra-low power wireless module intended for sensor networks applications. It offers the most on-chip RAM of 10kB and also a IEEE 802.15.4 Chipcon radio with an integrated on-board antenna providing up to 125 meters of range
  • The design of the sensor board is contributed by Harvard University as part of their ongoing research in project CodeBlue.It offers a combined hardware and software platform that provides protocols for device recovery and publish/subscribe multihop routing, as well as simple query interface that is tailored for medical monitoring.
  • The ECG lead extensions from the sensor board are pin-compatible and color coded to standard 3-Lead ECG monitoring systems. While there are different flavors of physiological chest leads, this system is designed to match any 3-Lead ECG Snap Set 19 Lead wires.