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Deactivation of Implantable Cardioverter Defibrillator Extravasation of IV Amiodarone Anticoagulation for AF, DVT and PE Patients Returning from Interventional Cardiac Procedure Cardiology Referrals STEMI Thrombolysis Protocol STEMI Hypertensive Emergencies Rate Control in AF Heart Failure Aortic Dissection Non ST Elevation MI (NSTEMI) Suspected Acute Coronary Syndrome Pericardiocentesis Pacemakers Indications for Echocardiography Bradycardia Narrow Complex Tachycardia Anti-Platelet Therapy in Coronary Heart Disease Management of Acute AF Rhythm Control in AF Atrial Fibrillation Hypertension Ventricular Tachycardia Cardiogenic Shock Complicating Acute Coronary Syndrome Telemetry
Home | Articles | Cardiac | Telemetry

Telemetry

Last updated 14th June 2024

Introduction

  1. These are guidelines to be used in conjunction with individual patients’ clinical situation and assessment.
  2. If you require further advice/support please contact on call consultant cardiologist who would be happy to provide further advice.
  3. All patients on telemetry will be reviewed on a daily basis by the clinician requesting it and a decision made as to whether it is necessary to continue monitoring.
  4. Please remember there are only 10 telemetry units for use throughout the hospital.
  5. Do not remove to allow patients to shower. If a patient insists, they should be advised that this is against medical advice and that this will be documented in their case notes

Class I: Cardiac monitoring is indicated in most, if not all, patients in this group.

  1. This category includes all patients who are at significant risk of an immediate life-threatening arrhythmia. If a patient is required to leave a fixed monitored bed, such as in Critical Care, for diagnostic or therapeutic procedures, then cardiac monitoring should be continued with a portable, battery-operated monitor-defibrillator used by a healthcare provider who is skilled in telemetry interpretation and defibrillation.
    1. Proven or suspected myocardial infarction
    2. Post cardiac surgery, cardiac arrest, or catheter ablation
    3. Unstable angina
    4. Drug poisoning known to have arrhythmic toxicity  e.g, digitalis,tricyclic antidepressants, phenothiazines, antiarrhythmic
    5. Post percutaneous transluminal angioplasty with complications
    6. High-risk coronary artery lesions, critically ill patients
    7. Mobitz type II block or greater/Prolonged QTc/Known WPW syndrome
    8. Sustained ventricular tachycardia
    9. Myocarditis
    10. Loading type I/III anti arrhythmic agents (high risk) eg quinidine, lignocaine, mexiletine, flecanide, amiodarone, sotalol, dronedarone
    11. Patients With a Temporary Pacemaker or Transcutaneous Pacing Pads
    12. Following implantation of pacemaker, pacemaker dependent patients should be monitored until their first check is complete (usually 12 hours)
    13. Post implantation of ICD for 24 hours
    14. Patients with indications for Critical Care such as major trauma, acute respiratory failure, sepsis, shock, acute pulmonary embolus, major non-cardiac surgery, renal failure with electrolyte abnormalities (e.g. hyperkalaemia)
    15. Significant risk of Cardiac or Respiratory arrest

Class II: Cardiac monitoring may be of benefit in some patients but is not considered essential for all patients.

    1. Syncope
    2. More than 3 days post myocardial infarction
    3. Potentially lethal arrhythmia several days after control
    4. Significant non–life-threatening arrhythmia such as atrial fibrillation (including new Stroke patients for up to 48 hours)
    5. Pericarditis
    6. Hypotension
    7. Post cardiac surgery (stable)
    8. Loading type I/III anti arrhythmic agents (low risk)
    9. Tachyarrhythmia/brady arrhythmia

Class III: Cardiac monitoring is not indicated because a patient’s risk of a serious event is so low that monitoring has no therapeutic benefit.

    1. Postoperative patients at low risk
    2. Patients receiving end of life care (in this context, being patients who are in their last few days of life)
    3. Post routine uncomplicated coronary angiography
    4. Chronic stable Atrial fibrillation
    5. Stable cardiac disease or obstetrics
    6. End Stage Renal Disease

Telemetry Pathway

 

Links

Telemetry Indication Form [pdf]

Content by Sue Bryant