Vetter N J, Julian D G
Lancet. 1975 May 24;1(7917):1151-4. doi: 10.1016/s0140-6736(75)93134-7.
Conventional methods of monitoring arrhythmias impose heavy demands on staff and are unreliable. On-line arrhythmia computers have been developed to overcome these problems, but there has been no critical evaluation of the functioning of such a system in a clinical setting. A comparison was made of the efficacy of two methods of monitoring in detecting arrhythmias in sixty-four patients in a coronary-care unit. Half the patients were monitored by a commercially available arrhythmia computer; the other half were monitored by conventional means with a rate-triggered alarm system. More than 99 percent of episodes of potentially serious ventricular arrhythmias were detected by the computer; 95 percent of patients with these arrhythmias were treated immediately. In those monitored by conventional means, a large proporation of such arrhythmias were unrecognised: only 17 percent of affected patients received immediate antiarrhythmic therapy. In 30 percent, treatment was delayed for several hours, and none was given in 52 percent. False alarms occurred with both systems but were more readily recognised as such in the computer-monitored patients. It is concluded that an arrhythmia computer improves the standards of arrhythmia detection, leads to quicker institution of treatment, and diminishes the demand on skilled staff.
传统的心律失常监测方法对工作人员要求很高且不可靠。为克服这些问题，人们开发了在线心律失常计算机，但尚未在临床环境中对该系统的功能进行严格评估。对冠心病监护病房的64例患者采用两种监测方法检测心律失常的效果进行了比较。一半患者由市售的心律失常计算机进行监测；另一半采用传统方法并配备心率触发报警系统进行监测。计算机检测出了超过99%的潜在严重室性心律失常发作；95%患有这些心律失常的患者立即得到了治疗。在采用传统方法监测的患者中，很大一部分此类心律失常未被识别：只有17%的受影响患者接受了立即抗心律失常治疗。30%的患者治疗延迟了数小时，52%的患者未接受任何治疗。两种系统均出现了误报，但在计算机监测的患者中更容易识别。结论是心律失常计算机提高了心律失常检测的标准，能更快地开始治疗，并减少了对技术人员的需求。
