False Positive or Life-Threatening? The Difference Multi-Channel Monitoring Makes.

A real-world example from TZ Medical Monitoring Solutions

Can you guess the rhythm?
At first glance, this strip looks like Ventricular Tachycardia, a rapid, potentially life-threatening rhythm.

What is Ventricular Tachycardia (VT)?
Ventricular Tachycardia (VT) is a wide complex tachycardia, defined as > 3 consecutive beats originating in the ventricles at a rate of > 100 bpm. Types of VT include Sustained VT (> 30s), Nonsustained (> 3 beats < 30s; terminating spontaneously), Monomorphic (stable QRS morphology from beat to beat), Polymorphic (changing or multiform QRS morphology from beat to beat), and Bidirectional (beat-to-beat alternation in QRS frontal plane axis). VT is a potentially life-threatening arrhythmia, and it is responsible for the majority of sudden cardiac deaths in the United States. ^{1 2}

Why it matters:

• Can cause dizziness, chest pain, fainting

• Sustained VT can lead to sudden cardiac arrest

• Often triggers urgent physician notifications and specialist referrals

Key characteristics:

• Origin: Ventricles (lower chambers)

• Rate: > 100 bpm (often much higher)

• Effect: Potential hemodynamic instability

Severity:

• Non-sustained VT: Brief, may be benign

• Sustained VT: >30 seconds orrequires intervention, life-threatening

However…
After reviewing the single-channel strip, the TZ technician enabled channels 2 and 3 to verify the findings.

FALSE POSITIVE.
Luckily, the 3-channel recording captured by TZ's Trident monitor ruled out VT and verified the rhythm as Normal Sinus.

"Here is a 47-year-old who would likely be seeing an EP, ASAP, for symptomatic VT....except it's NSR. Even if the technician and providers suspected artifact rather than true VT, they could not, in good conscience, treat it as anything less than VT. 2 channels presenting a wide-complex >300 bpm >3s tachycardia, correlating with symptoms, leave clinicians with no good option. Who knows how many times patients and clinicians have had to respond to similar tracings as real, hoping they aren't, without enough data to make a better decision?"
-Josiah Rice; ECG Technician, TZ Medical Monitoring Solutions

The Moral of the Multi-Channel Story
While a multi-channel AECG recording does promote both redundancy (increased likelihood of viable data capture during high-artifact episodes) and accuracy (secondary and tertiary vectors to verify beat morphology), the true impact goes far beyond the ECG strip.

If the device had only captured a single channel of ECG:

• Would the rhythm have triggered an urgent alert to the provider for VT?

• Would the patient have been referred to an Electrophysiologist?

• Would the patient have been subjected to additional testing to verify or rule out VT?

• What impact would this have on the patient's peace of mind?

Instead, with TZ Medical Monitoring Solutions:

• The patient's report included accurate preliminary findings for the physician's final interpretation

• The patient avoided unwarranted downstream care, stress, and anxiety

• The practice avoided wasted time and resources

Why Multi-Channel Matters
Accurate Rhythm Analysis = Better Patient Outcomes

Multi-channel AECG monitoring doesn't just capture more data; it also provides a more complete picture. It prevents unnecessary escalation & unwarranted resource expenditure, and it empowers Physicians to make an accurate and reliable diagnosis of their patients' ECG.

"Not-so-little scenarios like these are what drive us to go the extra mile for our clients every day. They connect the dots between the long hours, the attention to detail, and the painstaking effort to deliver products and services that are Sparked by Your Ideas. If only one patient's experience with their AECG study is improved, we are beyond grateful to have played some small part in their healthcare journey. But, from our team to yours, our goal is to provide this level of care for every client and patient who puts their trust in TZ."
--Kyle Robinson; Director, TZ Medical Monitoring Solutions