Sensitivity of rhythm disturbance detection by community hospital telemetry

Telemetry is done in a variety of settings with different levels of sophistication. The American College of Cardiology has made suggestions for telemetry monitoring but these are not in place in many smaller community hospitals that do telemetry monitoring. The objective of this study was to compare prospectively telemetry without a dedicated monitor watcher or full disclosure to results obtained on full disclosure. Patients included were admitted to a single community hospital with an indication for telemetry as judged by their primary physician. Telemetry results reported by the hospital staff were compared to over-read of full disclosure traces by an academic cardiology service and the patient was used as his own control. Significant rhythm disturbances including pauses of 2 seconds or greater and short runs of ventricular and supraventricular tachycardia were frequently missed when a dedicated monitor watcher and full disclosure were not in use. When a dedicated monitor watcher and full disclosure are not in use, telemetry results should be accepted with caution and attempts should be made to improve monitoring.