{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:28:17Z","timestamp":1747182497202,"version":"3.40.5"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Continuous cardiac monitoring has been recommended for ED patients being evaluated for possible acute coronary syndrome (ACS) due to concern for arrhythmia, although evidence suggests this risk is low. Indiscriminate use of monitored beds restricts access for other critically unwell patients and contributes to overcrowding. The objective of the present study was to determine if a low\/intermediate\u2010risk HEART score identified patients at very low risk for a clinically important arrhythmia who could be removed from cardiac monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single centre, retrospective, cohort study of consecutive ED patients in a tertiary referral hospital evaluated for possible ACS from July to August 2017. Patients with ST\u2010elevation myocardial infarction or an arrhythmia at presentation which would mandate monitoring were excluded. Data was obtained by medical chart review. The primary outcome was the occurrence of an arrhythmia requiring treatment while in ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Inter\u2010rater reliability for data extraction demonstrated very strong agreement (kappa 0.87, 95% confidence interval 0.83\u20130.91). There were 653 participants included with 83 (12.7%) having a final diagnosis of ACS. Three (0.5%) clinically important arrhythmias occurred. There were no cases of ventricular tachycardia, ventricular fibrillation or cardiac arrest. Five hundred and forty (82.7%) participants were low\/intermediate\u2010risk HEART score and one (0.2%) clinically important arrhythmia occurred (this was supraventricular tachycardia treated by a valsalva manoeuvre).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among ED patients presenting with a possible ACS, a low\/intermediate\u2010risk HEART score identified those at very low risk for having a clinically important arrhythmia while in ED.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13818","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T05:42:52Z","timestamp":1624513372000},"page":"29-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The <scp>HEART<\/scp> score to identify emergency department patients suspected of an acute coronary syndrome who can be removed from cardiac monitoring: A retrospective chart review"],"prefix":"10.1111","volume":"34","author":[{"given":"Jason","family":"Oh","sequence":"first","affiliation":[{"name":"Emergency Department St George Hospital  Sydney New South Wales Australia"},{"name":"St George and Sutherland Clinical School, Faculty of Medicine The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6245-672X","authenticated-orcid":false,"given":"Stephen Edward","family":"Asha","sequence":"additional","affiliation":[{"name":"Emergency Department St George Hospital  Sydney New South Wales Australia"},{"name":"St George and Sutherland Clinical School, Faculty of Medicine The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000527"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.12.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv320"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.160742"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.02.004"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-2026.2002.00380.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(00)00640-9"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2005.05.015"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.01.255"},{"key":"e_1_2_8_11_1","first-page":"360","article-title":"Understanding Interobserver agreement: the kappa statistic","volume":"37","author":"Viera AJ","year":"2005","journal-title":"Fam. 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