A winter virus has been blamed for a sharp fall in the performance of the ambulance service in Wales in December.
Only 47.6% of of category A emergencies received a response within the eight-minute target, down nearly 10% on the previous month, new figures show.
It was short of the 65% target set by the assembly government in April.
The Welsh Ambulance Service NHS Trust said a "flu-like virus" had caused a higher number of emergency calls than last year.
It also put increased pressure on A&E units, which caused the handover of patients from ambulance staff to be delayed, and this further affected performance, the trust said.
In Torfaen, 17.9% of emergency responses arrived within the eight-minute target and only three Local Health Boards (LHBs) - Wrexham, Denbighshire and Conwy - reached the 65% target.
Health Minister Edwina Hart wants 65% of ambulances across Wales to reach patients within the target time by March.
She called the released ambulance response times "dreadful" but said that December had been a difficult month.
The board of the Welsh Ambulance Service NHS Trust is to meet in Cwmbran later, and will receive a report showing that performance for January is showing an upward trend.
The trust said it received 300 000 emergency calls in December, up 10% on the previous year.
Ambulances had to deal with an extra 82 incidents each day compared with normal.
'Major challenges'
A trust spokesperson said: "Activity was already up by approximately 16.4% on last year before the holiday period. When the seasonal activity increase was added to this, it gave us a number of major challenges, not least in its effect on accident and emergency departments .
"Due to increased pressures at A&E departments across Wales, the handover of patients from Ambulance staff was delayed, which further impacted on performance.
"We are continuing to work closely with NHS colleagues to see if there are any actions that we have not already taken which might resolve issues around the delays we have been experiencing in a number of areas while waiting to be able to hand patients to the care of hospital staff.
The Welsh Assembly Government said: "We have worked with the Welsh Ambulance Service and hospitals to plan for this period. Three regional winter pressure groups were established with the responsibility for co-coordinating services during this period."
'Stalled investment'
Conservative health spokesman Jonathan Morgan said there was "a whole system failure" in the NHS in Wales.
"We cannot solve this problem by merely shouting orders at the ambulance service," he said.
"And the assembly government cannot expect standards to improve when they are asking the ambulance service to making millions of pounds worth of efficiency savings."
Liberal Democrat Peter Black said: "Much-needed investment in the ambulance service has stalled with the assembly government.
"A bid put into assembly government in January 2008 for £5m to be spent on ambulance fleets has not yet been approved, over a year later. Another bid of £35m submitted in May 2008 is also awaiting approval."
In December, Ms Hart said the ambulance service must "raise its game and work with its staff and partner organisations to improve services for patients" after statistics showed that the service's performance in reaching category A calls had worsened since June.
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