Continuous cardiac monitoring is an important tool in the clinical assessment of patients with a variety of conditions. It allows the detection of changes in heart rate, rhythm and conduction, and is essential in the detection of life threatening arrhythmias. This is achieved using a cardiac monitor, connected to a cable lead and skin electrodes, which captures the electrical activity predominantly through a single view (commonly lead II).
The monitor function includes:
- A display of heart rate and rhythm
- Sound alarms above or below pre-set limits
- The provision of rhythm strips to document evidence of arrhythmia
Alarms should never be ignored or turned off.
Patients who may require cardiac monitoring include those who are haemodynamically compromised and/or at clinical risk of adverse events, for example, patients with:
- Chest pain
- Palpitations
- Acute Coronary Syndrome – STEMI, NSTEMI, unstable angina
- Following major surgery – ITU, HDU, cardiac surgery
- Major trauma
- Post cardiac/respiratory arrest
- Acute medical conditions –
- Pulmonary embolus, drug overdose, electrolyte imbalance
- Unexplained syncope episodes
- Shock
- Undergoing a specific treatment
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The cardiac monitor or telemetry system will be connected to the patient via a 3- or 5-lead cable. This will now be explained.
Static bedside cardiac monitor system:
- ECG signal detected from patient electrodes, transmitted to oscilloscope /monitor screen via a monitor lead cable
- Displays ECG rhythm continuously
- ECG maybe duplicated to a central console monitoring station
- Some systems incorporate computerised software that recognises life threatening cardiac arrhythmias, sounds an alarm, stores data
Telemetry monitoring: portable wireless cardiac monitoring system:
- Allows transmission of the ECG without requiring the patient to be attached to a static monitor
- A patients standard chest electrodes and lead cable are connected to small portable monitor transmitter carried in a chest harness /pyjama pocket
- Cardiac rhythm is transmitted to a receiver unit at a central monitoring station, where the rhythm is displayed continuously
- Suitable for ambulatory cardiac patients requiring ongoing ECG monitoring
- The device is battery powered
Page last reviewed: 30 Jul 2020
