Impact of Emergent Physician Notifications from Mobile Cardiac Outpatient Telemetry on Patient Outcomes (The EP-COT...

Mobile ambulatory cardiac telemetry (MCOT) use has increased over time; however, data on the prevalence and the impact of emergent arrhythmia notifications with MCOT remains unclear. We sought to determine the prevalence and clinical impact of emergent arrhythmia events in patients undergoing MCOT monitoring. We also analyzed the efficiency of the emergent notification process.

We analyzed 8404 consecutive patients from two centers who were prescribed Philips MCOT (K153473) over a 28-month period (September 2018-January 2021). Participants meeting emergent notification criteria were included. The primary outcome was any unscheduled provider intervention after the emergent notification. We also analyzed several time domains of the provider notification process.

A total of 122 patients (1.45%) satisfied emergent notification criteria during the study period. The median notification time from arrhythmia onset to provider notification was 42 min. Physician review of the arrhythmia notifications showed agreement with the monitoring technician diagnosis in 102/122 (83.6%). An emergent notification resulted in an unscheduled follow-up visit in 104/122 (85.2%) patients. Time from arrhythmia event to unscheduled follow up visit was < 24 h in 88/104 (84.6%), 24-72 h in 9/104 (8.7%) and > 72 h in 7/104 (6.7%). In 33 patients (27%), emergent notifications resulted in unscheduled interventions including: device implantation (24), ablation (8), and electrical cardioversion (4).

Emergent arrhythmias events recorded during ambulatory telemetry monitoring resulted in unscheduled patient contact in 85% of cases and procedures in 27% of cases. The monitoring notification process was efficient, with median time from arrhythmia onset to provider notification of 42 min.