Premature ventricular complexes during continuous electrocardiographic monitoring in the intensive care unit: Occurrence rates and associated patient characteristics

Suba, Sukardi; Hoffmann, Thomas J.; Fleischmann, Kirsten E.; Schell-Chaple, Hildy; Prasad, Priya; Marcus, Gregory M.; Badilini, Fabio; Hu, Xiao-Yang; Pelter, Michele M.

doi:10.1111/jocn.16408

Cited by 3 publications

(1 citation statement)

References 48 publications

(64 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, none of the six PVC types were associated with VT in both unadjusted and adjusted logistic regression models. Our findings show that some patients may generate a high number of PVC alarms yet are not at higher risk for VT. Other investigators examining arrhythmia alarms, not specifically PVCs, have reported similar findings regarding high alarm counts in a subset of patients (Cvach et al, 2015;Drew et al, 2014;Nguyen et al, 2020;Suba et al, 2022). Identifying this subgroup of patients could be useful when developing patient-specific alarm management strategies.…”

Section: Association (Aha) Practice Standards For Ecg Monitoring In H...mentioning

confidence: 68%

Evaluation of premature ventricular complexes during in‐hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort

Suba

Hoffmann

Fleischmann

et al. 2023

Research in Nursing & Health

Self Cite

View full text Add to dashboard Cite

In-hospital electrocardiographic (ECG) monitors are typically configured to alarm for premature ventricular complexes (PVCs) due to the potential association of PVCs with ventricular tachycardia (VT). However, no contemporary hospital-based studies have examined the association of PVCs with VT. Hence, the benefit of PVC monitoring in hospitalized patients is largely unknown. This secondary analysis used a large PVC alarm data set to determine whether PVCs identified during continuous ECG monitoring were associated with VT, in-hospital cardiac arrest (IHCA), and/or death in a cohort of adult intensive care unit patients. Six PVC types were examined (i.e., isolated, bigeminy, trigeminy, couplets, R-on-T, and run PVCs) and were compared between patients with and without VT, IHCA, and/or death. Of 445 patients, 48 (10.8%) had VT; 11 (2.5%) had IHCA; and 49 (11%) died. Isolated and run PVC counts were higher in the VT group (p = 0.03 both), but group differences were not seen for the other four PVC types. The regression models showed no significant associations between any of the six PVC types and VT or death, although confidence intervals were wide. Due to the small number of cases, we were unable to test for associations between PVCs and IHCA. Our findings suggest that we should question the clinical relevance of activating PVC alarms as a forewarning of VT, and more work should be done with larger sample sizes. A more precise

show abstract

Section: Association (Aha) Practice Standards For Ecg Monitoring In H...mentioning

confidence: 68%

Evaluation of premature ventricular complexes during in‐hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort

Suba

Hoffmann

Fleischmann

et al. 2023

Research in Nursing & Health

Self Cite

View full text Add to dashboard Cite

show abstract

Technical article: Overview of hospital-based data capture systems that acquire continuous ECG and physiologic data

Pelter,

Prasad,

Mortara

et al. 2024

Journal of Electrocardiology

View full text Add to dashboard Cite

Hospital-Based Electrocardiographic Monitoring: The Good, the Not So Good, and Untapped Potential

Pelter

2024

American Journal of Critical Care

View full text Add to dashboard Cite

Continuous electrocardiographic (ECG) monitoring was first introduced into hospitals in the 1960s, initially into critical care, as bedside monitors, and eventually into step-down units with telemetry capabilities. Although the initial use was rather simplistic (ie, heart rate and rhythm assessment), the capabilities of these devices and associated physiologic (vital sign) monitors have expanded considerably. Current bedside monitors now include sophisticated ECG software designed to identify myocardial ischemia (ie, ST-segment monitoring), QT-interval prolongation, and a myriad of other cardiac arrhythmia types. Physiologic monitoring has had similar advances from noninvasive assessment of core vital signs (blood pressure, respiratory rate, oxygen saturation) to invasive monitoring including arterial blood pressure, temperature, central venous pressure, intracranial pressure, carbon dioxide, and many others. The benefit of these monitoring devices is that continuous and real-time information is displayed and can be configured to alarm to alert nurses to a change in a patient’s condition. I think it is fair to say that critical and high-acuity care nurses see these devices as having a positive impact in patient care. However, this enthusiasm has been somewhat dampened in the past decade by research highlighting the shortcomings and unanticipated consequences of these devices, namely alarm and alert fatigue. In this article, which is associated with the American Association of Critical-Care Nurses’ Distinguished Research Lecture, I describe my 36-year journey from a clinical nurse to nurse scientist and the trajectory of my program of research focused primarily on ECG and physiologic monitoring. Specifically, I discuss the good, the not so good, and the untapped potential of these monitoring systems in clinical care. I also describe my experiences with community-based research in patients with acute coronary syndrome and/or heart failure.

show abstract

Premature ventricular complexes during continuous electrocardiographic monitoring in the intensive care unit: Occurrence rates and associated patient characteristics

Cited by 3 publications

References 48 publications

Evaluation of premature ventricular complexes during in‐hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort

Evaluation of premature ventricular complexes during in‐hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort

Technical article: Overview of hospital-based data capture systems that acquire continuous ECG and physiologic data

Hospital-Based Electrocardiographic Monitoring: The Good, the Not So Good, and Untapped Potential

Contact Info

Product

Resources

About