ECG alarms during left ventricular assist device (LVAD) therapy in the ICU

Abstract

BackgroundIn hospitalized patients with left ventricular assist device (LVAD), electrical interference and low amplitude QRS complexes are common, which could impact the accuracy of electrocardiographic (ECG) arrhythmia detection and create technical alarms. This could contribute to provider alarm fatigue and threaten patient safety. ObjectivesWe examined three LVAD patients in the cardiac intensive care unit (ICU) to determine: 1) the frequency and accuracy of audible arrhythmia alarms; 2) occurrence rates of technical alarms; and 3) alarm burden (# alarms/hour of monitoring) MethodsSecondary analysis. ResultsDuring 593 h, there were 549 audible arrhythmia alarms and 98% were false. There were 25,232 technical alarms and 93% were for artifact, which was configured as an inaudible text alert. ConclusionFalse-arrhythmia and technical alarms are frequent in LVAD patients. Future studies are needed to identify both clinical and algorithm-based strategies to improve arrhythmia detection and reduce technical alarms in LVAD patients.