Continuous Electrocardiographic Monitoring and Cardiac Arrest Outcomes in 8,932 Telemetry Ward Patients
Open accessAbstract
Abstract. Objective: To estimate the benefit of routine electrocardiographic (ECG) telemetry monitoring on in‐hospital cardiac arrest survival. Methods: In a tertiary care hospital, all telemetry ward admissions and cardiac arrests occurring over a five‐year period were reviewed. Ward location and survival to discharge were determined for all patients outside of critical care areas. Results: During the study period, 8,932 patients were admitted to the telemetry ward, and 20 suffered cardiac arrest (0.2%; 95% CI = 0.1 to 0.3). Telemetry monitors signaled the onset of cardiac arrest in only 56% (95% CI = 30 to 80) of monitored arrests. Three patients survived to discharge, and in two of these three patients the arrest onset was signaled by the monitor. This yields a monitor‐signaled survival rate among telemetry ward patients of 0.02% (95% CI = 0 to 0.05). All survivors suffered significant arrhythmias prior to their cardiac arrests. Conclusions: Cardiac arrest is an uncommon event among telemetry ward patients, and monitor‐signaled survivors are extremely rare. Routine telemetry offers little cardiac arrest survival benefit to most monitored patients, and a more selective policy for telemetry use might safely avoid ECG monitoring for many patients.
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In one report of nearly 9,000 patients evaluated longitudinally, 20% of non-ICU cardiac arrests occurred in unmonitored patients.
“In one discouraging report of nearly 9,000 patients evaluated longitudinally, 20% of non-ICU cardiac arrests occurred in unmonitored patients (Schull & Redelmeier, 2000).”
From 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry (2017) · cites this paper as Schull & Redelmeier, 2000
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- Authors
- Schull, M. J., & Redelmeier, D. A.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Schull, Michael J.
- Venue
- Academic Emergency Medicine
- Publisher
- Wiley
- Published
- 2000-06
- Volume
- 7
- Issue
- 6
- Pages
- 647-652
- ISSN
- 1069-6563 (ISSN-L)
- 1553-2712
- OpenAlex
- W2025564415
- Cited by
- 70
- References
- 36
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 7 · 2017: 6 · 2016: 3 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 3
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Academic Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- cardiac arrest, continuous ECG monitoring, cardiac arrhythmias
- MeSH terms
- Aged, Female, Follow-Up Studies, Heart Arrest, Humans, Male, Middle Aged, Monitoring, Physiologic, Ontario, Sensitivity and Specificity, Telemetry, Electrocardiography, Ambulatory, Survival Rate, Confidence Intervals
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