Introduction: In-hospital telemetry monitoring is recommended in all patients with ACS to reveal severe arrhythmias and sudden cardiac death. According to the Practice Standards for Electrographic Monitoring by AHA all patients with preliminary ACS diagnoses have Class I indication for telemetry monitoring. The aims of the study were to investigate the number of in-hospital arrhythmias, and whether arrhythmias versus non-arrhythmias predict long-term survival in ACS patients.
Methods: A prospective observational design was applied. All adult patients assigned to in-hospital telemetry monitoring at one university hospital during a three month period in 2009-2010 were consecutively enrolled (N=1194). A registration data sheet with sixty-four variables was developed, completed by monitor watchers at the central monitor station, and reviewed by the investigator. Data were collected 24/7. Medical records were reviewed in all patients and re-reviewed in the ACS population (n=422) seven years after hospital discharge.
Results: Of the 422 ACS patients, 69% were men and mean age was 65 years. Only 23% of the patients experienced arrhythmic events, of which 1.4% was serious adverse events like third degree AV-block, sustained ventricular tachycardia and asystole. Of the entire ACS population, 24% died within seven years after hospital discharge. There were no significant differences in survival rates in patients with and without arrhythmic events during hospital stay (OR 1.6, 95% CI 0.79-3.25, p=0.189).
Conclusion: ACS patients under in-hospital telemetry monitoring had low rates of adverse arrhythmia events. No significant differences in patients with and without in-hospital arrhythmias in long-term survival challenge the AHA’s Practice Standard as cardiac monitoring is recommended in all ACS patients. Further investigations in a larger population of ACS patients are required.