Is telemetry overused? Is it as helpful as thought?

Cardiac telemetry is widely used in hospitals, but it is expensive and labor-intensive. Therefore, it should be used only in those most likely to benefit. The authors review the available evidence and offer their recommendations. Key points Guidelines from the American College of Cardiology (1991) and American Heart Association (2004) divide patients into three risk classes for whom telemetry is, may be, or is not indicated. Few studies have addressed whether telemetry is beneficial in clinical practice. The available evidence suggests that telemetry infrequently influences physician management decisions for patients at low risk, although it may in a relatively small subset at high risk. Inappropriate use of telemetry is associated with unnecessary testing and treatment and higher cost of care. Better risk-assessment and selection strategies are needed to identify patients for whom telemetry monitoring will be most beneficial.