The incidence of cardiac arrhythmia using telemetry, portable ECG monitors, in inpatients at faculty of medicine tertiary care hospital

Background: Cardiac arrhythmias represent a significant clinical complication among hospitalized patients, particularly in those with underlying cardiovascular disease. Continuous telemetry monitoring provides real-time electrocardiographic surveillance, enabling prompt detection and management of life-threatening arrhythmias. However, despite widespread global implementation, Thailand currently lacks standardized institutional guidelines for telemetry monitoring utilization. Understanding the incidence and patterns of arrhythmias in the Thai population is essential for developing evidence-based monitoring protocols.

Methods: A cross-sectional study was conducted at Ramathibodi Hospital, a tertiary care medical institution in Bangkok, Thailand. A total of 331 hospitalized patients aged 18 years and older who underwent continuous telemetry monitoring between June 2022 and December 2022 were included. Clinical data were systematically extracted from electronic health records, including patient demographics, arrhythmia classification according to American Heart Association criteria, arrhythmia types, frequency of episodes, and clinical management approaches. Data were analyzed using descriptive statistics.

Results: Cardiac arrhythmias were documented in 212 of 331 patients (64.05%). According to American Heart Association classification, the majority of patients were classified as Class II arrhythmias (118 of 212, 55.60%). A total of 387 distinct arrhythmic episodes were detected. The most frequently observed arrhythmia patterns were: premature ventricular contractions (34.37%), premature atrial contractions (19.90%), and atrial fibrillation (15.76%). Other detected arrhythmias included supraventricular tachycardia (8.01%), sinus bradycardia (7.75%), and atrioventricular block (3.61%). Conservative clinical observation was the predominant management approach (41.69%), followed by pharmacological intervention. Hospital discharge was the primary reason for discontinuing telemetry monitoring (59.21%).

Conclusions: This study demonstrates a substantial incidence of cardiac arrhythmias (64.05%) detected through continuous telemetry surveillance in hospitalized patients. Premature ventricular contractions emerged as the most prevalent arrhythmic pattern. These findings underscore the clinical utility of telemetry monitoring and support the urgent need for developing standardized monitoring protocols and clinical guidelines specific to Thai healthcare institutions. Implementing such protocols would enhance patient safety, improve clinical decision-making, and optimize resource utilization in tertiary care settings.

Nalinee Niyomthai holds a position in the Nursing Services Division at the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. With extensive experience in clinical nursing practice in coronary care units and patient monitoring systems, Nalinee has developed specialized expertise in cardiac care and telemetry monitoring technologies. Her professional focus encompasses improving patient safety through advanced monitoring techniques and optimizing healthcare delivery in tertiary care settings. Nalinee is committed to advancing nursing knowledge and contributing to evidence-based practice in cardiac telemetry monitoring. She has actively participated in research initiatives aimed at establishing standardized clinical protocols and guidelines for hospitalized patients with cardiac complications, with particular emphasis on developing Thai-specific monitoring standards for tertiary care institutions.