![]() ![]() Arrhythmia was searched with other key words ( ventricular arrhythmias, atrial arrhythmias, sinus bradycardia, atrioventricular block). ECG monitoring was searched in the context of patient populations such as acute coronary syndrome ( myocardial infarction, STEMI, NSTEMI, therapeutic hypothermia, targeted temperature management, angina, unstable angina, chest pain, vasospastic angina, percutaneous coronary intervention, open heart surgery). ![]() Key search words included arrhythmia, dysrhythmia, ST-segment monitoring, QTc monitoring, and torsade de pointes, among other terms. Searches were extended to studies, reviews, and previous related scientific statements or guidelines from the AHA, ACC, American Association of Critical-Care Nurses, or Heart Rhythm Society that were published in English and accessible through PubMed Medline, CINAHL, Cochrane, and other selected relevant databases. As more studies are published that include financial analyses, these data can be reviewed in future practice standards. Data on costs for electrocardiographic monitoring are limited at this time therefore, the main outcomes of the current practice standards will continue to be the degree to which evidence exists to support the usefulness and effectiveness of continuous electrocardiographic monitoring. The writing group included nurses, cardiologists, and a hospitalist.Įxperts from the writing group were asked to perform a literature review of select topics and inpatient populations, to evaluate the strength of evidence for electrocardiographic monitoring, and to provide recommendations on indications for electrocardiographic monitoring. The current writing group is composed of experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology and included experts in alarm management. A member of the American College of Cardiology (ACC) was formally appointed for the update to practice standards. The current update to practice standards was similarly approved, with appointments of interprofessional experts from the AHA’s Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Disease in the Young, and Council on Clinical Cardiology. The aim was to encompass all areas of hospital electrocardiographic monitoring, including arrhythmia, ST-segment ischemia, and QT-interval monitoring in both children and adults. ![]() The 2004 practice standards 1 were commissioned by the AHA Manuscript Oversight Committee on the basis of a proposal from the AHA’s Council on Cardiovascular Nursing, along with support from the Council on Cardiovascular Disease in the Young and the Council on Clinical Cardiology. This document does not contain recommendations for other forms of electrocardiographic monitoring, including the static 12-lead ECG, exercise testing, or ambulatory electrocardiographic (Holter) monitoring. For this document, the writing group reviewed research published since 2004 to provide updated recommendations for indications, duration, and implementation indications for continuous electrocardiographic monitoring in hospitalized patients. Since then, however, further data and new issues have emerged that need to be more fully addressed: overuse of arrhythmia monitoring among a variety of patient populations, underuse of QT-interval and ST-segment monitoring among select populations, alarm fatigue, and documentation in electronic health records. The first American Heart Association (AHA) scientific statement on practice standards for electrocardiographic monitoring in hospital settings was published in 2004 1 and provided an interprofessional, comprehensive review of evidence and recommendations for continuous electrocardiographic monitoring of hospitalized patients. The goals of electrocardiographic monitoring have expanded from simple heart rate and basic rhythm determination to the diagnosis of complex arrhythmias, the detection of acute and often silent myocardial ischemia, and the identification of drug-induced prolonged QT interval. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology. ![]()
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