Use and Outcomes of Telemetry Monitoring on a Medicine Service

Telemetry is a powerful tool for real-time monitoring of a patient's heart rhythm and QRS pattern. Beds with telemetry monitoring are limited and expensive in most institutions; therefore, the use of this resource would ideally be evidence based.¹ American Heart Association (AHA) guidelines provide class I, II, and III indications for the use of telemetry, but the focus is almost exclusively on cardiac diagnoses, such as admissions for rule-out acute coronary syndrome or heart block.² However, there are far fewer data that describe criteria for the use of telemetry in a general medical population.³ In the largest study of telemetry to date, only 121 of 2240 patients (5%) who underwent telemetry were admitted with noncardiac diagnoses.⁴ We performed a study to better characterize the reasons why patients on a medicine service are placed on telemetry monitoring as well as the frequency of clinically significant telemetry events.