Outcomes of patients hospitalized to a telemetry unit

Estrada, Carlos A.; Prasad, Niraj K.; Rosman, Howard; Young, Mark

doi:10.1016/0002-9149(94)90403-0

Cited by 44 publications

(27 citation statements)

References 25 publications

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“…[322][323][324][325][326] Moreover, in noncardiac patients, serious and fatal arrhythmias tend to be a secondary manifesta tion of serious underlying comorbidities, and signs and symptoms of worsening clinical status do not require telemetry to detect. [327][328][329] In fact, the few studies sug gest that the rationale for monitoring may to be more to detect and manage a broad range of complications, not just arrhythmias or myocardial ischemia.…”

Section: Medical Conditionsmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

207

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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Section: Medical Conditionsmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

207

214

View full text Add to dashboard Cite

show abstract

“…The attempt in 1991 through the American College of Cardiology to clarify criteria for telemetry was in the opinion of this participant overly liberal. 2 This was confirmed by the subsequent papers by Estrada and colleagues, 3,4 which evaluated these criteria. Nonetheless, the use of telemetry has remained in large part because it is difficult scientifically, politically, and culturally to unravel the issues that push for the telemetry monitoring of patients.…”

Section: Commentariesmentioning

confidence: 84%

The Costs of Inadequate Data

Jaffe

2000

Academic Emergency Medicine

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“…Interrater agreement was good in a pilot study ( ϭ 0.8). 2 The study was approved by the Human Rights Committee at Henry Ford Hospital.…”

Section: Methodsmentioning

confidence: 99%

“…2 We subsequently reported the results of a larger study that found telemetry in this setting rarely detected arrhythmias that resulted in the transfer of patients to an intensive care unit (0.8%) and uncommonly detected arrhythmias that led to urgent interventions or a change in medication (7%), but our analyses did not look for differences among the three ACC classes. 3 In this study, we use the data from our larger study to determine whether there are differences in the frequency or the clinical significance of the arrhythmias that occur in patients in the three ACC classes when they are being monitored in a non-intensive-care setting.…”

mentioning

confidence: 96%

Evaluation of guidelines for the use of telemetry in the non-intensive-care setting

et al. 2000

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To determine if the American College of Cardiology (ACC) cardiac monitoring guidelines accurately stratify patients according to their risks for developing clinically significant arrhythmias in non-intensive-care settings, we conducted a prospective cohort study of 2,240 consecutive patients admitted to a non-intensive-care telemetry unit over 7 months. Sixty-one percent of patients were assigned to ACC class I (telemetry indicated in most patients), 38% to class II (telemetry indicated in some), and 1% to class III (telemetry not indicated). Arrhythmias were detected in 13.5% of the class I patients, 40.7% of the class II patients, and 12% of the class III patients ( p Ͻ .001). Telemetry detected an arrhythmia resulting in transfer to an intensive care unit in 0.4% of the class I patients, 1.6% of the class II patients, and none of the class III patients ( p ϭ .006). Telemetry led to a change in management for 3.4% of the class I patients, 12.7% of the class II patients, and 4% of the class III patients ( p Ͻ .001). When patients with chest pain as the reason for admission were moved from class I to class II and patients with arrhythmias as the reason for admission were moved from class II to class I, more arrhythmias and more clinically significant arrhythmias occurred in class I patients and the trends from class I to class III were more consistent with the purpose of the guidelines. These findings indicate that when the ACC guidelines are reexamined, consideration should be given to changing them so they are more useful in non-intensive-care settings.

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Outcomes of patients hospitalized to a telemetry unit

Cited by 44 publications

References 25 publications

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

The Costs of Inadequate Data

Evaluation of guidelines for the use of telemetry in the non-intensive-care setting

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