Performance comparison of 6 in-hospital patient monitoring systems in the detection and alarm of ventricular cardiac arrhythmias

Nicola Cosentino; Xuan Zhang; Emily J Farrar; Halit O Yapici; René Coffeng; Heikki Vaananen; John W Beard

doi:10.1016/j.cvdhj.2024.02.002

Performance comparison of 6 in-hospital patient monitoring systems in the detection and alarm of ventricular cardiac arrhythmias

Cardiovasc Digit Health J. 2024 Feb 12;5(2):70-77. doi: 10.1016/j.cvdhj.2024.02.002. eCollection 2024 Apr.

Authors

Nicola Cosentino¹, Xuan Zhang², Emily J Farrar², Halit O Yapici², René Coffeng³, Heikki Vaananen³, John W Beard⁴

Affiliations

¹ Monzino Cardiology Center, Milan, Italy.
² Boston Strategic Partners Inc., Boston, Massachusetts.
³ GE HealthCare, Helsinki, Finland.
⁴ GE HealthCare, Chicago, Illinois.

Abstract

Background: Patient monitoring devices are critical for alerting of potential cardiac arrhythmias during hospitalization; however, there are concerns of alarm fatigue due to high false alarm rates.

Objective: The purpose of this study was to evaluate the sensitivity and false alarm rate of hospital-based continuous electrocardiographic (ECG) monitoring technologies.

Methods: Six commonly used multiparameter bedside monitoring systems available in the United States were evaluated: B125M (GE HealthCare), ePM10 and iPM12 (Mindray), Efficia and IntelliVue (Philips), and Life Scope (Nihon Kohden). Sensitivity was tested using ECG recordings containing 57 true ventricular tachycardia (VT) events. False-positive rate testing used 205 patient-hours of ECG recordings containing no cardiac arrhythmias. Signals from ECG recordings were fed to devices simultaneously; high-severity arrhythmia alarms were tracked. Sensitivity to true VT events and false-positive rates were determined. Differences were assessed using Fisher exact tests (sensitivity) and Z-tests (false-positive rates).

Results: B125M raised 56 total alarms for 57 annotated VT events and had the highest sensitivity (98%; P <.05), followed by iPM12 (84%), Life Scope (81%), Efficia (79%), ePM10 (77%), and IntelliVue (75%). B125M raised 20 false alarms, which was significantly lower (P <.0001) than iPM12 (284), Life Scope (292), IntelliVue (304), ePM10 (324), and Efficia (493). The most common false alarm was VT, followed by nonsustained VT.

Conclusion: We found significant performance differences among multiparameter bedside ECG monitoring systems using previously collected recordings. B125M had the highest sensitivity in detecting true VT events and lowest false alarm rate. These results can assist in minimizing alarm fatigue and optimizing patient safety by careful selection of in-hospital continuous monitoring technology.

Keywords: Alarm fatigue; Electrocardiogram; Electrocardiographic monitoring; False alarm; Outcomes; Sensitivity; Specificity; Ventricular tachycardia.