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Title: The Utility of Ambulatory Electrocardiographic Monitoring for Detecting
Arrhythmias in an Urban Elderly Population with Heart Failure.
Background: Atrial and ventriclar tachyarrhythmias, as well as bradyarrhythmias, in the
elderly with heart failure (HF) and/or hypertension (HTN) have been well documented.
However, in patients 65 years or older, living in the community with HF and other
cardiovascular risk factors the frequency of these arrhythmias, whether silent or symptomatic,
and their association with subsequent cardiac events has not been well defined.
Aims: To assess the value of 2 weeks of remote cardiac monitoring for detecting arrhythmias in
an elderly population living with HF.
Methods: The study population consisted of 53 patients with a history of systolic HF and/or
HTN who consented to wear, an auto triggered cardiac loop monitor that captures EKG data and
both silent and symptomatic arrhythmias..
Results: Subjects averaged 73 ± 6 years with 60% females, 74% Hispanic, 23% black, and 4%
white/other. All patients had HF and 94% had HTN. From the cardiac monitoring, 72%
demonstrated ectopic atrial and ventricular activity. In addition, 1 paroxysmal episode of atrial
fibrillation (AF) was documented, 3 people had significant non-sustained ventricular tachycardia
and 4 individuals had severe bradycardia recorded on external cardiac monitoring. These 7
individuals underwent placement of an implantable cardioverter defibrillator or pacemakers
based on these finding. During follow-up 16 patients (30%) had significant cardiac events.
Conclusion: A substantial proportion of patients exhibited cardiac arrhythmias. Future morbidity
was prevented because of the detection of arrhythmias on monitoring that led to specific
therapies such as pacemaker or ICD implantation which otherwise would not have been
implemented.
Authors: Kathleen T. Hickey, EdD, ANP-BC, FNP-BC, James Reiffel, MD, Robert R. Sciacca,
EngScD, Angelo Biviano, MD, MPH, William Whang, MD, MS Maurita Baumeister, ANP-BC
Carmen Castillo, Jyothi Talathothi, B.A.M.S, and Hasan Garan, MD, MS
Author: Kathleen T. Hickey, EdD, ANP-BC, FNP-BC
SNRS member number and status: nonmember at time of submission
Institutional Affiliation: Columbia University School of Nursing, NY
Position title: Assistant Professor of Nursing
Disclosures: None
Co-author: James Reiffel, MD
Institutional Affiliation: The College of Physicians & Surgeons, Columbia University,NY
Position title: Professor of Clinical Medicine
Disclosures: None
Co-author: Robert R. Sciacca, Eng ScD,
Institutional Affiliation: The College of Physicians & Surgeons, Columbia University,NY
Position title: Research Scientist
Disclosures: None
Co-author: , Angelo Biviano, MD, MPH
Institutional Affiliation: The College of Physicians & Surgeons, Columbia University,NY
Position title: Assistant Professor of Medicine
Disclosures: None
Co-author: William Whang, MD, MS
Institutional Affiliation: The College of Physicians & Surgeons, Columbia University,NY
Position title: Assistant Professor of Medicine
Disclosures: None
Co-author: Maurita Baumeister, ANP-BC
Institutional Affiliation: Columbia University School of Nursing, NY
Position title: Acute Care Nurse Practitioner
Disclosures: None
Co-author: Carmen Castillo,
Institutional Affiliation: Columbia University School of Nursing, NY
Position title: Research Coordinator
Disclosures: None
Co-author: Jyothi Talathothi, B.A.M.S,
Institutional Affiliation: Columbia University School of Nursing, NY
Position title: Research Assistant
Disclosures: None
Co-author: Hasan Garan, MD, MS
Institutional Affiliation: The College of Physicians & Surgeons, Columbia University, NY
Position title: Director of Clinical Electrophysiology
Dsclosures: None