The use and effectiveness of electrocardiographic telemetry monitoring in a community hospital general care setting.
The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort study on 1097 telemetry admissions between January 1, 2000 and March 31, 2000. A convenience sample of 218 patients generated 236 telemetry admissions. One-hundred-sixty-two arrhythmic events were detected during 400 "indicated" telemetry days. Nine arrhythmic events were detected during 345 "not indicated" telemetry days. The relative rate for arrhythmic events was significantly different, at P < 0.0001, with the incidence rate ratio of 15 indicating a very large effect size. Consequently, current use of ECG telemetry may not be optimal, and a prospective analysis of the application of rigorous indications for ECG telemetry needs to be undertaken.


CONCLUSIONS
The application of standard criteria to electrocardiogram telemetry admissions found that the majority of abnormal heart rhythms were found when patients met appropriate criteria.
*Department of Anesthesiology and Critical Care, Hoag Memorial Presbyterian Hospital Newport Beach, CA, and the †Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA.
J Paul
JP
Curry
C William
CW
Hanson
Michael W
MW
Russell
Cheryl
C
Hanna
Gayle
G
Devine
E Andrew
EA
Ochroch
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation* / Q000706:statistics & numerical data*; D005189:False Positive Reactions; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D013686:Telemetry / Q000295:instrumentation* / Q000706:statistics & numerical data*