Abstract
Background: Continuous electrocardiographic (ECG) monitoring is used to identify ventricular tachycardia (VT), but false alarms occur frequently. Objective: The purpose of this study was to assess the rate of 30-day in-hospital mortality associated with VT alerts generated from bedside ECG monitors to those from a new algorithm among intensive care unit (ICU) patients. Methods: We conducted a retrospective cohort study in consecutive adult ICU patients at an urban academic medical center and compared current bedside monitor VT alerts, VT alerts from a new-unannotated algorithm, and true-annotated VT. We used survival analysis to explore the association between VT alerts and mortality. Results: We included 5679 ICU admissions (mean age 58 ± 17 years; 48% women), 503 (8.9%) experienced 30-day in-hospital mortality. A total of 30.1% had at least 1 current bedside monitor VT alert, 14.3% had a new-unannotated algorithm VT alert, and 11.6% had true-annotated VT. Bedside monitor VT alert was not associated with increased rate of 30-day mortality (adjusted hazard ratio [aHR] 1.06; 95% confidence interval [CI] 0.88–1.27), but there was an association for VT alerts from our new-unannotated algorithm (aHR 1.38; 95% CI 1.12–1.69) and true-annotated VT(aHR 1.39; 95% CI 1.12–1.73). Conclusion: Unannotated and annotated-true VT were associated with increased rate of 30-day in-hospital mortality, whereas current bedside monitor VT was not. Our new algorithm may accurately identify high-risk VT; however, prospective validation is needed.
Original language | English |
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Journal | Heart Rhythm O2 |
Volume | 4 |
Issue number | 11 |
Pages (from-to) | 715-722 |
ISSN | 2666-5018 |
DOIs | |
Publication status | Published - 2023 |
Bibliographical note
Publisher Copyright:© 2023 Heart Rhythm Society
Keywords
- Alarm fatigue
- Algorithm development
- Continuous electrocardiographic monitoring
- In-hospital mortality
- Intensive care unit
- Ventricular tachycardia