Usefulness of Routine Transtelephonic Monitoring for Supraventricular Tachycardia in Infants.

OBJECTIVE: We hypothesize that routine daily transtelephonic monitoring (TTM) transmissions can accurately detect supraventricular tachycardia (SVT) in asymptomatic infants and/or assuage parental concerns rather than being used solely to diagnose arrhythmias. STUDY DESIGN: Single center, retrospective chart review of 60 patients with fetal or infant SVT prescribed TTM for at least 30 days, January 2010-September 2016. Patients were excluded if initial SVT was not documented, was perioperative, was atrial flutter/fibrillation, or chaotic atrial tachycardia. Categorical variables expressed as mean ± SD. Mann-Whitney, Spearman correlation, and Fisher exact tests were used for continuous and categorical variables respectively. RESULTS: Sixty patients were included. There were 2688 TTM transmissions received from 55 of 60 patients over 61.1 ± 66.7 days (0.73 ± 0.65 TTM/patient/days). Routine asymptomatic TTM transmissions revealed actionable findings in 5 of 2801 TTM transmissions sent by 5 patients (8.3%). No patient presented in shock or died. Forty-five of 2688 TTM transmissions were sent for parental concerns/symptoms in 16 patients (25.8%) with findings of normal sinus rhythm in 37 of 45 TTM transmissions and SVT in 8 of 45 TTM transmissions. Symptomatic actionable findings were more likely sent by patients discharged on class I or III antiarrhythmics (95% CI = 11.5%-68.3%, P = .004) and patients with prolonged initial hospitalizations (95% CI = 6.98%-59.7%, P = .01). Flecainide was discontinued in 1 patient after widened QRS was noted on routine TTM. CONCLUSIONS: TTM accurately diagnose asymptomatic recurrent SVT in neonates and infants before they develop signs of congestive heart failure or shock and is helpful for recurrent SVT management.

Aspectos do uso territorial por onça parda (Puma concolor), através de monitoramento via satélite, na região do Parque Estadual da Serra do Brigadeiro, MG / Aspects of territorial use of the Cougar (Puma concolor), by satelite monitoring, in the Parque Estadual da Serra do Brigadeiro, MG

Objetivou-se com o presente estudo monitorar o comportamento do uso territorial de um macho de onça parda, capturado no Parque Estadual da Serra do Brigadeiro (PESB), por meio da telemetria, usando colar de GPS via Satélite Globalstar. O monitoramento de doze meses resultou na transmissão via satélite de 328 localizações, as quais sugerem que a área utilizada por esse felino seja de aproximadamente 610km2, sendo esta a maior área já descrita para a espécie. Foi possível observar que apenas 20% das localizações ocorreram dentro da área do PESB. O comportamento territorial observado neste trabalho mostra a vulnerabilidade do animal a ações antrópicas, como a caça, atropelamentos e o contato com patógenos entre animais silvestres e domésticos. Observou-se também que duas rodovias configuram barreiras artificiais para o deslocamento do animal, possivelmente impedindo o fluxo gênico entre o PESB e dois outros importantes parques. Com os dados levantados é possível a sugestão de ações de manejo, como a criação de uma conectividade efetiva entre o PESB, o Parque Estadual do Rio Doce e o Parque Nacional do Caparaó, o que poderia contribuir para o intercâmbio genético entre as populações e, dessa forma, favorecer a conservação não somente da onça parda.

We aimed to study the territorial behavior of a male cougar, captured in the Parque Estadual da Serra do Brigadeiro (PESB), using a GPS collar and the Globalstar Satellite. Monitoring the animal for nine months we obtained 328 locations. The data suggest that the area used by this feline is approximately 610km2, the largest area described for this specie. It was also possible to observe that only 20% of the locations of the animal occurred within the PESB area. The territorial behavior observed in this study shows the vulnerability of the animal to human activities such as hunting, road kill and contact with pathogens from domestic animals. It was also observed that two roads constitute artificial barriers for animal movement, possibly preventing gene flow between the PESB and two other parks. The creation of an effective connectivity between the PESB, the Parque Estadual do Rio Doce and the Parque Nacional do Caparaó is critical to ensure genetic exchange between the animal populations and thereby promote their conservation.

The use and effectiveness of electrocardiographic telemetry monitoring in a community hospital general care setting.

UNLABELLED: The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort study on 1097 telemetry admissions between January 1, 2000 and March 31, 2000. A convenience sample of 218 patients generated 236 telemetry admissions. One-hundred-sixty-two arrhythmic events were detected during 400 "indicated" telemetry days. Nine arrhythmic events were detected during 345 "not indicated" telemetry days. The relative rate for arrhythmic events was significantly different, at P < 0.0001, with the incidence rate ratio of 15 indicating a very large effect size. Consequently, current use of ECG telemetry may not be optimal, and a prospective analysis of the application of rigorous indications for ECG telemetry needs to be undertaken. IMPLICATIONS: The application of standard criteria to electrocardiogram telemetry admissions found that the majority of abnormal heart rhythms were found when patients met appropriate criteria.