Which patients outside of ICU setting should be placed on telemetry monitoring in the hospital?

Telemetry monitoring should be used in patients at increased risk of arrhythmias during hospitalization (1). While the American Heart Association provides expert opinion on telemetry for a variety of cardiac conditions (1), a more recent review (2) makes suggestions for common cardiac and non-cardiac diagnoses based on arrhythmia risk.

Telemetry is recommended for patients admitted for implantable cardioverter- defibrillaor firing, second or third degree AV block, prolonged QT interval with ventricular arrhythmia, acute heart failure, acute cerebrovascular event,  acute coronary syndrome and massive blood transfusion.

Telemetry may be beneficial in syncope with arrhythmia as a suspected cause, gastrointestinal hemorrhage after endoscopy, atrial arrhythmias on rate or rhythm control therapy, electrolyte imbalance and subacute congestive heart failure.

Telemetry is not generally indicated in chest pain with normal EKG and cardiac markers, COPD exacerbation, PE if the patient is stable and on anticoagulation, and cases requiring minor blood transfusion. 

 

References 

(1) Drew BJ, Califf RM, Funk M, et al. Practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association scientific statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses. Circulation 2004;110:2721–46. 

(2) Chen EH and Hollander JE. When do patients need admission to a telemetry bed? The Journal of Emergency Medicine 2007:33(1):53-60.

Contributed by Joome Suh, MD, Boston, MA

Which patients outside of ICU setting should be placed on telemetry monitoring in the hospital?

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