BACKGROUND The clinical utility of routine electrocardiographic monitoring following percutaneous coronary interventions (PCI) is not well studied. METHODS We prospectively evaluated the incidence, cost, and the clinical implications of actionable arrhythmia alarms on telemetry monitoring following PCI. One thousand three hundred fifty-eight PCI procedures (989 [72.8%] for acute coronary syndrome and 369 [27.2%] for stable angina) on patients admitted to nonintensive care unit were identified and divided into 2 groups; group 1, patients with actionable alarms (AA) and group 2, patients with non-AA. AA included (1) ≥3 s electrical pause or asystole; (2) high-grade Mobitz type II atrioventricular block or complete heart block; (3) ventricular fibrillation; (4) ventricular tachycardia (>15 beats); (5) atrial fibrillation with rapid ventricular response; (6) supraventricular tachycardia (>15 beats). Primary outcomes were 30-day all-cause mortality. Cost-savings analysis was performed. RESULTS Incidence of AA was 2.2% (37/1672). Time from end of procedure to AA was 5.5 (0.5, 24.5) hours. Patients with AA were older, presented with acute congestive heart failure or non-ST-segment-elevation myocardial infarction, and had multivessel or left main disease. The 30-day all-cause mortality was significantly higher in patients with AA (6.5% versus 0.3% in non-AA [P<0.001]). Applying the standardized costing approach and tailored monitoring per the American Heart Association guidelines lead to potential cost savings of $622 480.95 for the entire population. CONCLUSIONS AA following PCI were infrequent but were associated with increase in 30-day mortality. Following American Heart Association guidelines for monitoring after PCI can lead to substantial cost saving.

中文翻译：

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经皮冠状动脉介入治疗后的常规连续心电图监测。

背景技术对经皮冠状动脉介入治疗（PCI）之后的常规心电图监测的临床实用性尚未进行很好的研究。方法我们前瞻性地评估了可动性心律失常警报在PCI术后遥测监测中的发生率，成本和临床意义。确定了接受非重症监护病房的患者的138例PCI手术（急性冠状动脉综合征为989例[72.8％]，稳定型心绞痛为369例[27.2％]），分为两组。第1组为具有可操作警报（AA）的患者，第2组为非AA的患者。包括AA（1）≥3 s的电停顿或心搏停止；（2）高档Mobitz II型房室传导阻滞或完全性心脏传导阻滞；（3）室颤；（4）室性心动过速（> 15次）；（5）房颤具有快速的心室反应；（6）室上性心动过速（> 15次）。主要结局为30天全因死亡率。进行了成本节省分析。结果AA的发生率为2.2％（37/1672）。从程序结束到AA的时间为5.5（0.5，24.5）小时。AA患者年龄较大，表现为急性充血性心力衰竭或非ST段抬高型心肌梗塞，并患有多支血管或左主干疾病。AA患者的30天全因死亡率显着更高（6.5％对比非AA患者为0.3％[P <0.001]）。根据美国心脏协会的指导方针，采用标准化的成本核算方法和量身定制的监控手段，可以为整个人群节省622 480.95美元的成本。结论PCI术后AA很少见，但与30天死亡率增加有关。遵循美国心脏协会的PCI后监测指南可以节省大量成本。