Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

David Cone, MD


Rapid prehospital electrocardiographic diagnosis of myocardial infarction in the setting of left bundle branch block and artificially paced rhythms is clinically challenging. Electrocardiographic findings of these conditions can mask classic findings of myocardial infarction, which can lead to significant treatment delays in these patient populations. We propose a randomized controlled trial evaluating prehospital measurement of troponin, in patients with left bundle branch block or paced rhythms, presenting with symptoms of acute coronary syndrome. We hypothesize that this prehospital measurement will reduce delays to percutaneous coronary intervention in patients with myocardial infarction. We will implement the use of point-of-care troponin assays to be completed by paramedics, with findings relayed to receiving facilities. Improving rates of early intervention in myocardial infarction has been shown to be beneficial in reducing morbidity and mortality. Prehospital measurement of troponin could be uniquely beneficial in patient populations who have low rates of early intervention.

Open Access

This Article is Open Access