ABSTRACT
Research on traditional cardiac telemetry demonstrates that excessive alarms are related to lead failures and noise-related interruptions. Patch-based continuous cardiac rhythm monitoring (CCRM) has emerged in outpatient ambulatory monitoring situations as a means to improve recording fidelity. In this study, patients hospitalized but not in the intensive care unit were simultaneously monitored via telemetry in parallel with the use of the Vital Signs Patch™ (VSP) CCRM system (LifeWatch Services, Rosemont, IL, USA), applying standardized monitoring and notifications provided by an off-site central monitoring unit (CMU). Among 11 patients (55% male; age: 66.8 ± 12.5 years), there were 42 CMU detections and 98 VSP detections. The VSP device was successfully applied by nursing with connectivity established in all 11 patients (100%). There were no VSP device-related adverse events or skin eruptions during the study. The CMU agreed with 59 (60%) of 98 VSP detections. Among those detections marked by disagreement 30 (77%) of 39 VSP detections were related to clinically meaningful arrhythmias (atrial: n = 9; ventricular: n = 7; brady-: n = 14) undetected by VSP due to noise. In two patients (18%), there were four clinically meaningful atrial fibrillation detections not recorded by the CMU. In conclusion, patch-based CCRM requires further development and review to replace traditional cardiac telemetry monitoring but could evolve into an appropriate method to detect clinically meaningful events missed by traditional methods if noise issues can be mitigated.
ABSTRACT
OBJECTIVES: We examined if an education intervention [EduI] based on the Common Sense Model theoretical framework and 3-step action plan to control fluid-related symptoms and weight gain, decreased 6-month health care consumption. BACKGROUND: Heart failure (HF) morbidity is often related to fluid overload. METHODS: A 2-group comparative design with convenience sampling was used to assess rehospitalization (Hosp), emergency department (ED) and unplanned office visits. Analyses included regression models. RESULTS: Of 122 usual care [UC] and 122 EduI patients, mean (standard deviation) age was 65.8 (12.6) years. In multivariate analyses, first HF Hosp, total ED visits and ED visits for HF decompensation were lower in EduI compared to UC; p = 0.039, p = 0.025, and p = 0.001 respectively. There were no reductions in 6-month total Hosp or HF-related unplanned office visits. CONCLUSIONS: An EduI with a 3-step action plan to control fluid-related symptoms and weight gain reduced first Hosp, total ED and HF-ED visits.
