Feasibility and Usability of Patch-based Continuous Cardiac Rhythm Monitoring in Comparison with Traditional Telemetry in Noncritically Ill Hospitalized Patients

Abstract

Research on traditional cardiac telemetry demonstrates that excessive alarms are related to lead failures and noise-related interruptions. Patch-based continuous cardiac rhythm monitoring (CCRM) has emerged in outpatient ambulatory monitoring situations as a means to improve recording fidelity. In this study, patients hospitalized but not in the intensive care unit were simultaneously monitored via telemetry in parallel with the use of the Vital Signs Patch™ (VSP) CCRM system (LifeWatch Services, Rosemont, IL, USA), applying standardized monitoring and notifications provided by an off-site central monitoring unit (CMU). Among 11 patients (55% male; age: 66.8 ± 12.5 years), there were 42 CMU detections and 98 VSP detections. The VSP device was successfully applied by nursing with connectivity established in all 11 patients (100%). There were no VSP device-related adverse events or skin eruptions during the study. The CMU agreed with 59 (60%) of 98 VSP detections. Among those detections marked by disagreement 30 (77%) of 39 VSP detections were related to clinically meaningful arrhythmias (atrial: n = 9; ventricular: n = 7; brady-: n = 14) undetected by VSP due to noise. In two patients (18%), there were four clinically meaningful atrial fibrillation detections not recorded by the CMU. In conclusion, patch-based CCRM requires further development and review to replace traditional cardiac telemetry monitoring but could evolve into an appropriate method to detect clinically meaningful events missed by traditional methods if noise issues can be mitigated.

Cardiac Monitoring: Then and Now

“…8 The articles featured in this issue span this increasingly diverse area within electrophysiology. Amuthan et al 9 present a fascinating evaluation of patch monitoring in the hospital setting, which has the potential to improve detection as well as make every hospital bed into a "telemetry" bed. Ferrara et al offer a unique case study involving His-bundle pacing and device follow-up with remote monitoring.…”