Appropriate Usage of Continuous Cardiac Monitoring in the Inpatient Setting: A Literature Review

Electrocardiographic monitoring (telemetry) in the inpatient setting has significant utility, but is constrained by rising healthcare costs, rare detection of significant events and potential for great alert fatigue [1, 2]. In 2017, the American Heart Association (AHA) published updated practice standards for telemetry monitoring that addressed overuse, appropriate use, alarm management and documentation in electronic medical records [3, 4]. Here, we review their recommendations for indication for telemetry utilization on the hospital floor. The rationale for arrhythmia monitoring is for diagnosis and management of arrhythmias, assessing for etiology of syncope, immediate recognition of sudden cardiac arrest to improve time to defibrillation, and catching sustained, life-threatening arrhythmias [5, 6].