What question did this study set out to answer?

To review the clinical utility, lead configurations, and practical implementation requirements of continuous ST-segment monitoring for patients with acute coronary syndrome.

May 1, 2001AJN American Journal of Nursing

Setting a New Gold Standard

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Population

Patients with acute coronary syndrome, unstable angina, acute myocardial infarction, or postcoronary…

Design

Review

Authors

ADAnn M. DaleidenUniversity of California San Francisco Medical Center HSHildy SchellUniversity of California, San Francisco

Discussion

Member takes

Implication

Supports broader ACS monitoring protocols for silent ischemia; leaves open outcome impact without prospective trials.

Key Points

To review the clinical utility, lead configurations, and practical implementation requirements of continuous ST-segment monitoring for patients with acute coronary syndrome.
Reviewed multilead ECG configurations including Mason-Likar, Frank vectorcardiography, and EASI systems for ischemia detection.
Synthesized clinical consensus guidelines detailing monitoring durations, high-risk observation windows, and lead-selection strategies based on culprit coronary arteries.
Continuous ST-segment monitoring detects silent, atypical, and recurrent myocardial ischemia that standard static 12-lead electrocardiograms frequently miss.
Guidelines recommend 24 to 48 hours of monitoring for unstable angina or infarction, measuring ST deviation 60 to 80 ms after the J point with alarms set 1 to 2 mm from baseline.

Structured PICO

Population

Patients with acute coronary syndrome (ACS), unstable angina, acute myocardial infarction (AMI), or postcoronary intervention, as well as emergency department patients with chest pain and postoperative surgery patients.

Intervention

Continuous ST-segment monitoring using various lead configurations (Mason-Likar, Frank, EASI).

Continuous ST-segment monitoring is a valuable but underused tool for detecting silent ischemia and monitoring reperfusion in ACS patients, requiring structured implementation and appropriate lead configurations.

Cite This Study

Daleiden et al. (2001) studied this question.

synapsesocial.com/papers/6a89168fd5f4e697bb13214a https://doi.org/10.1097/00000446-200105001-00002

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