Potential solutions for managing real-time ECG/arrhythmia monitoring alarms: A review

Electrocardiographic monitoring, which allows for continuous non-invasive detection and documentation of cardiac arrhythmia, is one of the most frequently used monitoring procedures for managing in-hospital patients. The most often cited issue of using these systems is the large number of alarms generated by these systems. These alarms include both false alarms and repetitive non-actionable true alarms. This paper provides an overview of potential solutions for managing these alarms. Device based solutions for false alarm reduction include a) providing more specific information in assisting users to identify the root cause of the false alarms, and b) continuing the development of more robust ECG and multi-parameter based algorithms. Frequent repetitive non-actionable alarms can be reduced and managed by developing a more robust alarm generation structure. An overview of the key features/components of a robust alarm generation structure is provided with an example to show how such a system could be used to manage and reduce the repetitive non-actionable alarms. Despite continuous development of the computerized ECG/arrhythmia monitoring systems over the last several decades, numerous opportunities still exist to further improve the usability of these systems. In addition to continuous algorithm enhancement (both ECG and multi-parameter based), other potential areas for enhancement include: better user support tools for trouble-shooting and work around, and better and more flexible alarm generation structures.