Routine Continuous Electrocardiographic Monitoring Following Percutaneous Coronary Interventions.
Circ Cardiovasc Interv
; 13(1): e008290, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31884835
ABSTRACT
BACKGROUND:
The clinical utility of routine electrocardiographic monitoring following percutaneous coronary interventions (PCI) is not well studied.METHODS:
We prospectively evaluated the incidence, cost, and the clinical implications of actionable arrhythmia alarms on telemetry monitoring following PCI. One thousand three hundred fifty-eight PCI procedures (989 [72.8%] for acute coronary syndrome and 369 [27.2%] for stable angina) on patients admitted to nonintensive care unit were identified and divided into 2 groups; group 1, patients with actionable alarms (AA) and group 2, patients with non-AA. AA included (1) ≥3 s electrical pause or asystole; (2) high-grade Mobitz type II atrioventricular block or complete heart block; (3) ventricular fibrillation; (4) ventricular tachycardia (>15 beats); (5) atrial fibrillation with rapid ventricular response; (6) supraventricular tachycardia (>15 beats). Primary outcomes were 30-day all-cause mortality. Cost-savings analysis was performed.RESULTS:
Incidence of AA was 2.2% (37/1672). Time from end of procedure to AA was 5.5 (0.5, 24.5) hours. Patients with AA were older, presented with acute congestive heart failure or non-ST-segment-elevation myocardial infarction, and had multivessel or left main disease. The 30-day all-cause mortality was significantly higher in patients with AA (6.5% versus 0.3% in non-AA [P<0.001]). Applying the standardized costing approach and tailored monitoring per the American Heart Association guidelines lead to potential cost savings of $622 480.95 for the entire population.CONCLUSIONS:
AA following PCI were infrequent but were associated with increase in 30-day mortality. Following American Heart Association guidelines for monitoring after PCI can lead to substantial cost saving.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
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Telemetria
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Eletrocardiografia Ambulatorial
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Intervenção Coronária Percutânea
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Frequência Cardíaca
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article