Continuous electrocardiographic monitoring and cardiac arrest outcomes in 8,932 telemetry ward patients

Acad Emerg Med. 2000 Jun;7(6):647-52. doi: 10.1111/j.1553-2712.2000.tb02038.x.


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.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Confidence Intervals
  • Electrocardiography, Ambulatory / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Heart Arrest / diagnosis*
  • Heart Arrest / mortality*
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / statistics & numerical data
  • Ontario
  • Sensitivity and Specificity
  • Survival Rate
  • Telemetry / methods
  • Telemetry / statistics & numerical data*