Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 3, Number 1, February 2012, pages 16-22

Effectiveness of Telemetry Guidelines in Predicting Clinically Significant Arrhythmias in Hospitalized Patients

Figure 2. Comparison of the arrhythmia event rate in the “telemetry not indicated” verses “telemetry indicated group” for patients with atleast one arrhythmic event. Arrhythmia events were more frequent in patients who were in the “telemetry indicated” group.

Figure 3. Comparison of clinically significant event rate in indicated verses the not indicated group. Of the patients with at least one event on telemetry, 36% of the patients in the indicated group had clinically significant event verses 0% in the not indicated group.

**Table 1.** Patient Demographics and Baseline Clinical Characteristics
		Telemetry indicated	Telemetry not indicated	P value
MI: Myocardial Infarction; PPM: Permanent pacemaker; AICD: Automated implantable cardioverter defibrillator; CABG: Coronary artery bypass graft; PCI: Percutaneous coronary intervention.
Age (years)	Mean (SD)	66 (15)	64 (17)	n.s
Gender	Male %	54%	36%	0.008
Ethnicity	Asian/Pacific Islanders	5%	10%	n.s.
	Black	20%	13%	n.s.
	Non-black Hispanic	33%	24%	n.s.
	White	41%	51%	n.s.
	Other	< 1%	1%	n.s.
Past Medical History	Diabetes Mellitus	36%	27%	n.s.
	Hypertension	78%	66%	0.045
	Dyslipidemia	47%	30%	0.013
	Prior MI	22%	6%	0.002
	Heart Failure	25%	10%	0.007
	Arrhythmia	26%	10%	0.006
	Atrial Fibrillation	15%	10%	n.s.
	PPM/AICD	9%	6%	n.s.
	CAD	40%	17%	0.0004
	Smoker
	Never	49%	63%	n.s.
	Ever	31%	20%	n.s.
	Current	20%	17%	n.s.
Past Surgical History	PCI	20%	10%	0.049
	CABG	3%	6%	n.s.
	Other cardiac surgery	3%	3%	n.s.

Table 1. Patient Demographics and Baseline Clinical Characteristics

Telemetry indicated

Telemetry not indicated

P value

MI: Myocardial Infarction; PPM: Permanent pacemaker; AICD: Automated implantable cardioverter defibrillator; CABG: Coronary artery bypass graft; PCI: Percutaneous coronary intervention.

Age (years)

Mean (SD)

66 (15)

64 (17)

n.s

Gender

Male %

54%

36%

0.008

Ethnicity

Asian/Pacific Islanders

10%

n.s.

Black

20%

13%

n.s.

Non-black Hispanic

33%

24%

n.s.

White

41%

51%

n.s.

Other

< 1%

n.s.

Past Medical History

Diabetes Mellitus

36%

27%

n.s.

Hypertension

78%

66%

0.045

Dyslipidemia

47%

30%

0.013

Prior MI

22%

0.002

Heart Failure

25%

10%

0.007

Arrhythmia

26%

10%

0.006

Atrial Fibrillation

15%

10%

n.s.

PPM/AICD

n.s.

CAD

40%

17%

0.0004

Smoker

Never

49%

63%

n.s.

Ever

31%

20%

n.s.

Current

20%

17%

n.s.

Past Surgical History

PCI

20%

10%

0.049

CABG

n.s.

Other cardiac surgery

n.s.

**Table 2.** Clinical Indication for Telemetry Monitoring in the “Telemetry Indicated Group”
Indications for telemetry	% of patients
ACS: Acute coronary syndrome.
Rule out ACS	R/O ACS alone	42.6
	R/O ACS + Arrhythmias	9.9
	R/O ACS + Syncope	6.1
	R/O ACS + Others	4.2
ACS	ACS alone	9.4
	ACS + Arrhythmias	2.3
	ACS + Syncope	0
	ACS + Others	0
Arrhythmias	Arrhythmias alone	5.2
	Arrhythmias + Syncope	0.9
	Arrhythmias + Other	0.47
Syncope	Syncope alone	5.2
	Syncope + Others	0.47

Others	Others	10.9
	Others ± R/O ACS ± Arrhythmias ± Syncope	1.8

Table 2. Clinical Indication for Telemetry Monitoring in the “Telemetry Indicated Group”

Indications for telemetry

% of patients

ACS: Acute coronary syndrome.

Rule out ACS

R/O ACS alone

42.6

R/O ACS + Arrhythmias

9.9

R/O ACS + Syncope

6.1

R/O ACS + Others

4.2

ACS

ACS alone

9.4

ACS + Arrhythmias

2.3

ACS + Syncope

ACS + Others

Arrhythmias

Arrhythmias alone

5.2

Arrhythmias + Syncope

0.9

Arrhythmias + Other

0.47

Syncope

Syncope alone

5.2

Syncope + Others

0.47

Others

10.9

Others ± R/O ACS ± Arrhythmias ± Syncope

1.8

**Table 3.** Electrocardiographic Events Identified by Telemetry
Arrhythmia identified	Indicated	Not indicated	P value
Ventricular Fibrillation	0	0	n.s
Sustained Ventricular Tachycardia (> 30 seconds)	0	0	n.s
Non-sustained Ventricular Tachycardia (> 3 beats but less 30 seconds)	93	15	n.s.
Supraventicular Tachycardia (HR > 110, non-sinus)	21	8	0.042
Atrial Fibrillation with rapid ventricular response (HR > 110 bpm)	80	4	0.0075
Atrial Flutter with rapid ventricular response (HR > 110 bpm)	9	3	n.s
Sinus Bradycardia (HR < 50 bpm)	110	22	n.s
Pause > 3 seconds	5	1	n.s
Junctional Rhythm	0	0	n.s
Third-degree type II atrioventricular block	1	0	n.s.
Second-degree type II atrioventricular block	0	0	n.s.
Second-degree type I atrioventricular block	0	0	n.s.
Idioventricular Rhythm	17	0	n.s.
Total Number of Events	336	53	0.001

Table 3. Electrocardiographic Events Identified by Telemetry

Arrhythmia identified

Indicated

Not indicated

P value

Ventricular Fibrillation

n.s

Sustained Ventricular Tachycardia (> 30 seconds)

n.s

Non-sustained Ventricular Tachycardia (> 3 beats but less 30 seconds)

n.s.

Supraventicular Tachycardia (HR > 110, non-sinus)

0.042

Atrial Fibrillation with rapid ventricular response (HR > 110 bpm)

0.0075

Atrial Flutter with rapid ventricular response (HR > 110 bpm)

n.s

Sinus Bradycardia (HR < 50 bpm)

110

n.s

Pause > 3 seconds

n.s

Junctional Rhythm

n.s

Third-degree type II atrioventricular block

n.s.

Second-degree type II atrioventricular block

n.s.

Second-degree type I atrioventricular block

n.s.

Idioventricular Rhythm

n.s.

Total Number of Events

336

0.001