The Incidence of Clinically Significant ECG Abnormalities Detected by Routine Everyday ECG: The First Analysis from CCU/ICCU Patients in Siriraj Hospital
Thananya Boonyasirinant MD*, Jithathai Suksamai MNS**, Pannee Panintrarak BSc**, Supanee Chuayprasartwattana BSc***, Wandee Foosang BSc***, Rewat Phankingthongkum MD*
Affiliation : * Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ** ICCU Unit, Division of Medicine and Psychology Nursing, Department of Nursing, Siriraj Hospital, Mahidol University, Bangkok, Thailand *** CCU Unit, Division of Medicine and Psychology Nursing, Department of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Electrocardiography (ECG) has been routinely performed in all patients in CCU and ICCU in Siriraj Hospital
everyday in the morning until discharge for screening the abnormalities, such as ischemic changes and arrhythmia. Nevertheless,
the occurrence of ECG changes from everyday recording is not common and the real incidence has not been studied. There
is uncertainty regarding the benefit derived, when weighted with the cost and the time wasted from the routine everyday ECG.
Objective : The purpose of the present study was to demonstrate the incidence of ECG abnormalities that can be detected and
have the effects on treatment from the routine everyday ECG in the patients admitted in CCU and ICCU.
Material and Method: One hundred and ten patients, admitted in CCU/ICCU in Siriraj Hospital were consecutively enrolled
in the present study. Routine everyday 12 leads ECG was performed in the morning in all patients. ECG was interpreted by
2 cardiologists for the incidence and detail of ECG changes as compared to prior ECG. Furthermore, the incidence of those
changes that affected management was recorded. Disease spectra and onset of ECG changes were reported.
Results : ECG changes from routine everyday ECG was 52.7%, however 25.9% of these changes could be detected by
telemetry recorded in every CCU/ICCU patients. ECG changes which affected treatment were 20%, whereas 36.4% of them
could be detected by telemetry. Incidence was more pronounced in patients with acute coronary syndrome (ACS), heart failure
(HF) and arrhythmias, and found mostly within the first 4 days of hospitalization.
Conclusion : While ECG changes from routine everyday ECG occurred in half of the CCU/ICCU patients, one-fourth could
be detected by the telemetry recorded. ECG changes that affected treatment were much lower and found merely in one-fifth.
This incidence could lead to the limitation of every routine ECG to only high-risk patients during the high-risk period.
Keywords : Routine ECG, CCU/ICCU, ECG changes
