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Ambulatory telemetry useful for detecting life-threatening arrhythmias

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Ambulatory telemetry can provide lifesaving information that is unavailable with other modalities, new research suggests.

More than 26,000 patients with routine clinical indications – such as atrial fibrillation, conduction system disturbances, or syncope — wore a lightweight sensor that automatically transmitted arrhythmia data to a central station via cellular phone.

In a retrospective study, Dr. Alan Kadish from Northwestern University, Evanston, Illinois, and colleagues found that during an average of 3 weeks of monitoring, 5459 patients (21%) had arrhythmic events that met physician notification criteria.

In the American Journal of Cardiology on March 22nd, they report that 262 patients (1%) had potentially life-threatening arrhythmias, including 120 who had wide complex tachycardia (at least 15 beats at 120 beats/min or higher), 100 who had pauses of 6 seconds or longer, and 42 with sustained heart rates below 30 beats/min. A further 704 patients (3%) had narrow complex tachycardia (180 beats/min or higher at rest).

“The results demonstrated that in a large number of unselected patients referred for ambulatory cardiac telemetry, a low percentage but a significant number of patients developed life-threatening arrhythmias that could require immediate intervention,” the researchers say.

They note that immediate data transfer might not happen with patient-activated event monitors, because the rhythm disturbances might not produce symptoms, or the patient might be asleep or unable to initiate a phone call.

“Ambulatory cardiac telemetry may provide lifesaving clinical information that is unavailable using other techniques,” the authors conclude.

Dr. Kadish and three of his five coauthors serve as consultants to LifeWatch Services, Inc. (Rosemont, Illinois), the company that maintains the cardiac monitoring devices and collects the telemetry data.

Am J Cardiol 2010.