What is a telemetry (cardiac monitoring) rhythm strip?

From the Guidelines

Telemetry rhythm strips are continuous recordings of a patient's cardiac electrical activity captured through a wireless monitoring system, providing healthcare providers with a real-time or retrospective view of a patient's heart rhythm. These strips are used to detect arrhythmias, conduction abnormalities, and other cardiac events. The system typically uses 3-5 electrodes attached to the patient's chest that transmit signals to a central monitoring station where nurses and physicians can observe multiple patients simultaneously 1.

Key Characteristics of Telemetry Rhythm Strips

• They are commonly used in hospital settings for patients who require cardiac monitoring but don't need the intensive surveillance of an ICU.
• They are particularly valuable for monitoring patients with known cardiac conditions, those recovering from cardiac procedures, or patients on medications that may affect heart rhythm.
• The strips can be printed out at regular intervals or when abnormalities occur, providing documentation of the patient's cardiac status over time.
• Unlike a standard 12-lead ECG which gives a comprehensive snapshot at one moment, telemetry provides continuous surveillance, making it more likely to catch intermittent arrhythmias or changes in cardiac status that might otherwise go undetected.

Types of Cardiac Rhythm Monitors

• Nonphysician prescribed smartphone-based systems: commercially available smartphone–based systems that can record a rhythm strip when the patient has symptoms or continuously depending on the technology 1.
• Holter monitor: continuous recording for 24–72 h; up to 2 wk with newer models, used for symptoms frequent enough to be detected within a short period of monitoring 1.
• Patient-activated, transtelephonic monitor (event monitor): a recording device that transmits patient-activated data via an analog telephone line to a central remote monitoring station, used for frequent, spontaneous symptoms likely to recur within 2–6 wk 1.
• External loop recorder (patient or auto triggered): a device that continuously records and stores rhythm data over weeks to months, used for frequent, spontaneous symptoms potentially related to bradycardia or conduction disorder, likely to recur within 2–6 wk 1.
• External patch recorders: a patch device that continuously records and stores rhythm data, with patient-trigger capability, used as an alternative to external loop recorder 1.
• Mobile cardiac outpatient telemetry: a device that records and transmits data from preprogrammed arrhythmias or patient activation to a communication hub at the patient’s home, used for spontaneous symptoms related to syncope and rhythm correlation in high-risk patients whose rhythm requires real-time monitoring 1.
• Implantable cardiac monitor: a subcutaneously implanted device with a battery life of 2–3 y, used for recurrent, infrequent, unexplained symptoms, potentially related to bradycardia or conduction disorder after a nondiagnostic initial workup, with or without structural heart disease 1.

From the Research

Definition of Telemetry Rhythm Strip

A telemetry rhythm strip is a continuous electrocardiographic (ECG) monitoring of cardiac patients on a long-term basis, which allows for rapid recognition of life-threatening conditions, including complex arrhythmias and myocardial ischemia 2.

Purpose of Telemetry Rhythm Strip

The purpose of a telemetry rhythm strip is to:

• Detect and report relevant rhythm abnormalities 3
• Assess evolving risk factors and detect life-threatening events 4
• Guide medical treatment and interventions 5
• Reduce alarm fatigue and interruptions in patient care 6

Key Features of Telemetry Rhythm Strip

Some key features of telemetry rhythm strips include:

• Continuous ECG monitoring 3
• Ability to detect arrhythmias, such as atrial fibrillation, ventricular tachycardia, and AV block 3
• Ability to capture ST-segment changes and other ECG patterns 4
• Transmission of data to local caregivers or remote monitoring services 4

Types of Telemetry Monitoring

There are different types of telemetry monitoring, including:

• Mobile cardiac telemetry (MCT) which uses an algorithm-based detection strategy 3
• Continuous long-term electrocardiography (LT-ECG) monitoring which uses a human-based detection strategy 3
• Implantable loop recorders (ILRs) which can store representative rhythm strips or transmit them to a monitoring service 4