Sukardi Suba, Thomas J Hoffmann, Kirsten E Fleischmann, Hildy Schell-Chaple, Gregory M Marcus, Priya Prasad, Xiao Hu, Fabio Badilini, Michele M Pelter
{"title":"将院内心电图监测中的室早复极作为重症监护室队列中室性心动过速的预测指标进行评估。","authors":"Sukardi Suba, Thomas J Hoffmann, Kirsten E Fleischmann, Hildy Schell-Chaple, Gregory M Marcus, Priya Prasad, Xiao Hu, Fabio Badilini, Michele M Pelter","doi":"10.1002/nur.22314","DOIUrl":null,"url":null,"abstract":"<p><p>In-hospital electrocardiographic (ECG) monitors are typically configured to alarm for premature ventricular complexes (PVCs) due to the potential association of PVCs with ventricular tachycardia (VT). However, no contemporary hospital-based studies have examined the association of PVCs with VT. Hence, the benefit of PVC monitoring in hospitalized patients is largely unknown. This secondary analysis used a large PVC alarm data set to determine whether PVCs identified during continuous ECG monitoring were associated with VT, in-hospital cardiac arrest (IHCA), and/or death in a cohort of adult intensive care unit patients. Six PVC types were examined (i.e., isolated, bigeminy, trigeminy, couplets, R-on-T, and run PVCs) and were compared between patients with and without VT, IHCA, and/or death. Of 445 patients, 48 (10.8%) had VT; 11 (2.5%) had IHCA; and 49 (11%) died. Isolated and run PVC counts were higher in the VT group (p = 0.03 both), but group differences were not seen for the other four PVC types. The regression models showed no significant associations between any of the six PVC types and VT or death, although confidence intervals were wide. Due to the small number of cases, we were unable to test for associations between PVCs and IHCA. Our findings suggest that we should question the clinical relevance of activating PVC alarms as a forewarning of VT, and more work should be done with larger sample sizes. A more precise characterization of clinically relevant PVCs that might be associated with VT is warranted.</p>","PeriodicalId":54492,"journal":{"name":"Research in Nursing & Health","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351875/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of premature ventricular complexes during in-hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort.\",\"authors\":\"Sukardi Suba, Thomas J Hoffmann, Kirsten E Fleischmann, Hildy Schell-Chaple, Gregory M Marcus, Priya Prasad, Xiao Hu, Fabio Badilini, Michele M Pelter\",\"doi\":\"10.1002/nur.22314\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In-hospital electrocardiographic (ECG) monitors are typically configured to alarm for premature ventricular complexes (PVCs) due to the potential association of PVCs with ventricular tachycardia (VT). However, no contemporary hospital-based studies have examined the association of PVCs with VT. Hence, the benefit of PVC monitoring in hospitalized patients is largely unknown. This secondary analysis used a large PVC alarm data set to determine whether PVCs identified during continuous ECG monitoring were associated with VT, in-hospital cardiac arrest (IHCA), and/or death in a cohort of adult intensive care unit patients. Six PVC types were examined (i.e., isolated, bigeminy, trigeminy, couplets, R-on-T, and run PVCs) and were compared between patients with and without VT, IHCA, and/or death. Of 445 patients, 48 (10.8%) had VT; 11 (2.5%) had IHCA; and 49 (11%) died. Isolated and run PVC counts were higher in the VT group (p = 0.03 both), but group differences were not seen for the other four PVC types. The regression models showed no significant associations between any of the six PVC types and VT or death, although confidence intervals were wide. Due to the small number of cases, we were unable to test for associations between PVCs and IHCA. Our findings suggest that we should question the clinical relevance of activating PVC alarms as a forewarning of VT, and more work should be done with larger sample sizes. 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Evaluation of premature ventricular complexes during in-hospital ECG monitoring as a predictor of ventricular tachycardia in an intensive care unit cohort.
In-hospital electrocardiographic (ECG) monitors are typically configured to alarm for premature ventricular complexes (PVCs) due to the potential association of PVCs with ventricular tachycardia (VT). However, no contemporary hospital-based studies have examined the association of PVCs with VT. Hence, the benefit of PVC monitoring in hospitalized patients is largely unknown. This secondary analysis used a large PVC alarm data set to determine whether PVCs identified during continuous ECG monitoring were associated with VT, in-hospital cardiac arrest (IHCA), and/or death in a cohort of adult intensive care unit patients. Six PVC types were examined (i.e., isolated, bigeminy, trigeminy, couplets, R-on-T, and run PVCs) and were compared between patients with and without VT, IHCA, and/or death. Of 445 patients, 48 (10.8%) had VT; 11 (2.5%) had IHCA; and 49 (11%) died. Isolated and run PVC counts were higher in the VT group (p = 0.03 both), but group differences were not seen for the other four PVC types. The regression models showed no significant associations between any of the six PVC types and VT or death, although confidence intervals were wide. Due to the small number of cases, we were unable to test for associations between PVCs and IHCA. Our findings suggest that we should question the clinical relevance of activating PVC alarms as a forewarning of VT, and more work should be done with larger sample sizes. A more precise characterization of clinically relevant PVCs that might be associated with VT is warranted.
期刊介绍:
Research in Nursing & Health ( RINAH ) is a peer-reviewed general research journal devoted to publication of a wide range of research that will inform the practice of nursing and other health disciplines. The editors invite reports of research describing problems and testing interventions related to health phenomena, health care and self-care, clinical organization and administration; and the testing of research findings in practice. Research protocols are considered if funded in a peer-reviewed process by an agency external to the authors’ home institution and if the work is in progress. Papers on research methods and techniques are appropriate if they go beyond what is already generally available in the literature and include description of successful use of the method. Theory papers are accepted if each proposition is supported by research evidence. Systematic reviews of the literature are reviewed if PRISMA guidelines are followed. Letters to the editor commenting on published articles are welcome.