Association of clinical outcomes and the use of telemetry monitors in patients with advanced heart failure

Abstract

Abstract Background Telemetry is a remote technology transmitted by radio frequency that sends patients' electrocardiographic signals in real-time, through a Bluetooth wireless network to a monitor located in a cardiovascular intensive care unit (ICU). This device is indicated for patients admitted in hospital clinical units that need monitoring (24 hours) for previous history or risk of developing cardiac arrhythmias. Patients with advanced heart failure often receive inotropic/antiarrhythmic drugs in the cardiovascular ICU. When clinically stable, this type of patient can be discharged from the cardiovascular ICU and monitored remotely in hospital clinical units using telemetry. Purpose We aimed o evaluate the clinical profile of patients with telemetry and to associate those with advanced heart failure who receive inotropic/antiarrhythmic drugs with unfavorable composite outcomes (death or cardiac arrhythmia). Methods Retrospective cohort study. Telemetry records were collected by nurses from the cardiovascular intensive care unit of a public university hospital. The study period was from January 2020 to May 2022. All the procedures in this study were in accordance with the Helsinki Declaration and approved by the Institutional Ethics Committee. Results In a sample of 703 patients, the mean (±SD) age was 63.4 ± 14.4 years, predominantly male 452 (64.3%). The median stay of the monitored patients was 4 (2-7) days. Among the monitored patients, regarding telemetry indications, patients diagnosed with advanced heart failure who receive inotropic/antiarrhythmic drugs had a prevalence rate of 12.8%. Of these, 32 (35.6%) had at least 1 complication, identified by telemetry, related significantly to unfavorable composite outcomes (P<0.001). All these patients who had the event identification through telemetry received immediate assistance by the cardiovascular intensive care team. Conclusion The use of telemetry in patients with advanced heart failure who receive inotropic/antiarrhythmic drugs admitted to hospital clinical units was associated significantly with unfavorable composite outcomes. The early detection of clinical outcomes might be useful in decision-making and in reducing major complications.