To improve the ability to diagnose post-operative arrhythmias the American Heart Association recommends the use of atrial electrograms when atrial epicardial wires are available (Practice Standards for Electrocardiographic Monitoring in Hospital Setttings).
Here we have included some of the landmark articles discussing the use of the temporary atrial wires for post-operative rhythm identification.
Use of atrial epicardial electrodes to diagnose and treat postoperative arrhythmias in children, (1980), The American Journal of Cardiology.
“Previous studies have demonstrated the usefulness of temporary atrial wires after cardiac surgery in adults. This experience confirms that the technique is easy and safe and can be of great diagnostic and therapeutic value in children.”
Use of temporarily placed epicardial atrial wire electrodes for the diagnosis and treatment of cardiac arrhythmias following open-heart surgery, (1978), The Journal of Thoracic and Cardiovascular Surgery.
“Not only provides clear evidence of their clinical usefulness, but also reflects the fact that … the atrial wire electrodes are easy, rapid, reliable, effective, and safe.”
“Strongly supports the routine placement of temporary atrial epicardial wire electrodes in all patients undergoing open-heart operations.”
“Those managing the patients felt it was simpler and/or more efficacious to use the atrial epicardial wire electrodes. This was true not only for instances in which the atrial wire electrodes were invaluable for the diagnosis and treatment of serious or complicated arrhythmias, but also for the diagnosis and treatment of relatively straightforward arrhythmias.”
Atrial Electrograms After Cardiac Surgery: Survey of Clinical Practice, (2007), American Journal of Critical Care.
“Compared with conventional surface ECGs, atrial electrograms offer a more definitive means of assessing and interpreting rhythm abnormalities.”
Cardiac Surgical Nurses’ Use of Atrial Electrograms to Improve Diagnosis of Arrhythmia, (2010), American Journal of Critical Care.
“Use of atrial electrograms significantly increased overall arrhythmia interpretation scores. Nurses rated obtaining atrial electrograms as easy and interpreting the findings as moderately easy.”
“ Atrial electrograms can facilitate diagnosis of cardiac arrhythmias in these situations by magnifying atrial activity so that the activity can be seen more clearly than on an ECG.”
First-in-human use of a continuous real-time atrial electrogram monitoring device after cardiac surgery, (2021), HeartRhythm Case Reports.
“Atrial electrogram monitoring has been used for more accurate rhythm identification for the last 40 years and is even recommended in the American Heart Association Practice Standards for postoperative ECG monitoring. However, despite a long history and strong recommendation for its use, the atrial electrogram remains underutilized.”
“The AtriAmp (Atrility Medical, Madison, WI), was developed to improve postoperative rhythm identification by providing continuous real-time display of the atrial electrogram on the bedside monitor”
“This device is the first device to provide continuous atrial electrogram monitoring while, if required, at the same time allow for atrial pacing using a temporary pacemaker”