The efficacy of continuous ECG monitoring among low, intermediate, and high risk phase II cardiac rehabilitation patients

[摘要] Continuous electrocardiographic (CECG) monitoring is commonly used in Phase IIcardiac rehabilitation programs to detect complications resulting from exercise. It hasbeen suggested that high risk cardiac patients are more likely to experience a seriousevent during exercise sessions, and therefore should be monitored more closely.Stratifying risk implies that one can predict which patients are at an increased risk ofexperiencing complications during cardiac rehabilitation. To determine the usefulness ofCECG and the application of risk stratification, a retrospective 5-year study of 241Phase II patients was conducted. Risk stratification, based on AACVPR criteria resultedin 123 (51%) patients classified as low risk, 80 (33%) as intermediate risk, and 38(16%) as high risk. The Phase I1 exercise records were examined to identifyindividuals who had a significant event during Phase II. All documented events whichnecessitated physician intervention or cessation of the exercise session were recorded. Atotal of 3,877 exercise sessions were reviewed. Ninety-nine significant eventsoccurred in a total of 69 patients. Of the 99 total events, 57 (57%) were detectedthrough the use of CECG. With regard to risk level, it was found that 29 (24%) low, 27(34%) intermediate, and 13 (34%) high risk patients had at least one significantevent. Chi-square analysis revealed no significant (p > .05) difference in theproportion of patients within each stratified subgroup who experienced events. Sixty sixevents occurred within the first 3 weeks of program initiation, with 75% being.detected through CECG. These results indicate that CECG may be efficatious for detectingabnormalities during Phase II cardiac rehabilitation, especially during the first 3weeks of the program. Also, it appears that based on current risk stratificationguidelines, it may be difficult to predict which patients will have complications duringPhase II cardiac rehabilitation. The findings of this study may be helpful in formulatingstandardized monitoring guidelines for Phase II cardiac exercisers, and may also aid inrevising current risk stratification procedures.

[发布机构] University of Wisconsin

[效力级别] Heart - Diseases - Patients - Rehabilitation

[关键词] Patient monitoring - Evaluation;Heart - Diseases - Patients - Rehabilitation;Ambulatory electrocardiography - Evaluation