Ventricular tachycardia and in-hospital mortality in the intensive care unit

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  • Priya A. Prasad
  • Isaksen, Jonas L.
  • Yumiko Abe-Jones
  • Jessica K. Zègre-Hemsey
  • Claire E. Sommargren
  • Salah S. Al-Zaiti
  • Mary G. Carey
  • Fabio Badilini
  • David Mortara
  • Kanters, Jørgen K.
  • Michele M. Pelter

Background: Continuous electrocardiographic (ECG) monitoring is used to identify ventricular tachycardia (VT), but false alarms occur frequently. Objective: The purpose of this study was to assess the rate of 30-day in-hospital mortality associated with VT alerts generated from bedside ECG monitors to those from a new algorithm among intensive care unit (ICU) patients. Methods: We conducted a retrospective cohort study in consecutive adult ICU patients at an urban academic medical center and compared current bedside monitor VT alerts, VT alerts from a new-unannotated algorithm, and true-annotated VT. We used survival analysis to explore the association between VT alerts and mortality. Results: We included 5679 ICU admissions (mean age 58 ± 17 years; 48% women), 503 (8.9%) experienced 30-day in-hospital mortality. A total of 30.1% had at least 1 current bedside monitor VT alert, 14.3% had a new-unannotated algorithm VT alert, and 11.6% had true-annotated VT. Bedside monitor VT alert was not associated with increased rate of 30-day mortality (adjusted hazard ratio [aHR] 1.06; 95% confidence interval [CI] 0.88–1.27), but there was an association for VT alerts from our new-unannotated algorithm (aHR 1.38; 95% CI 1.12–1.69) and true-annotated VT(aHR 1.39; 95% CI 1.12–1.73). Conclusion: Unannotated and annotated-true VT were associated with increased rate of 30-day in-hospital mortality, whereas current bedside monitor VT was not. Our new algorithm may accurately identify high-risk VT; however, prospective validation is needed.

OriginalsprogEngelsk
TidsskriftHeart Rhythm O2
Vol/bind4
Udgave nummer11
Sider (fra-til)715-722
ISSN2666-5018
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This study was funded by the University of California, San Francisco (UCSF) School of Nursing Lipps Research Fund (PI: Dr Pelter). Dr Prasad reports personal fees from EpiExcellence, LLC, outside the submitted work. All other authors have no conflicts of interest to disclose. All authors attest they meet the current ICMJE criteria for authorship. Patient consent was waived by the Committee on Human Research because data were analyzed retrospectively, and the study did not influence clinical care. The research reported in this paper adhered to the Declaration of Helsinki guidelines and was approved by the Committee on Human Research (IRB No. 12-09723).

Funding Information:
This study was funded by the University of California, San Francisco ( UCSF ) School of Nursing Lipps Research Fund (PI: Dr Pelter).

Publisher Copyright:
© 2023 Heart Rhythm Society

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