Betty Kelly, RN, Nurse Manager, Telemetry Units (L) adjusts the transmitter box, which cardiac telemetry patient Charles O’Brien (R) keeps in his pocket.

Suddenly, Laura’s heart began to throb at an unaccustomed speed and she was overcome with dizziness. Her head swam and the room went around and around. And then it happened. She passed out.

Luckily, Laura regained consciousness within a short time. She had not been injured when she fell to the floor. Nonetheless, something was terribly wrong. Her heart simply would not quiet down.

A visit to her primary care physician resulted in her wearing a Holter cardiac monitor. The read-out helped her physician to trace the unexplained fainting, known as syncope, to a sudden cardiac arrhythmia - an abnormality in the electrical function of the heart. Laura and her family were frightened, and uncertain about what it all meant.

Laura was referred to the Electrophysiology Laboratory at Winthrop, part of the Institute for Heart Care, where she underwent a cardiac ablation. This procedure effectively neutralized the area of the heart’s muscle that had caused the arrhythmia. Electrophysiologist Todd J. Cohen, MD, Director of the Hospital’s Electrophysiology and Cardiac Arrhythmia Laboratory, prescribed 24 hours of in-hospital monitoring for Laura. Still uncertain about her future, Laura found herself in a bed on Winthrop’s Gardner 2 Pavilion, one of the Hospital’s two telemetry units.

Monitored and cared for by compassionate, well-trained nurses and support staff, Laura was able to go home the following morning. The cardiac ablation, and the subsequent return to normal heart rhythms, made it possible for her to resume her hectic daily life as a wife, mother, and, very importantly, a healthy young woman.

Who needs cardiac monitoring? For patients who have suffered heart attacks, chest pain (angina), syncope, or a cardiac arrhythmia, cardiac telemetry monitoring is the next necessary step in recovery. Telemetry patients undergo around-the-clock cardiac monitoring for a prescribed period of time.

Telemetry is also the next level of care for cardiac patients who have undergone a major cardiac intervention, such as cardiac catheterization, or the implantation of a pacemaker device, but no longer need the intensive care provided in Cardiac or Medical Intensive Care Units.

Some of the patients, such as Laura, may have experienced a sudden cardiac arrhythmia, and have undergone specialized treatment in Winthrop’s Electrophysiology Laboratory. Some who have experienced syncope may have been treated with medication, or implanted with the Reveal® device, a thumb-sized probe which helps to diagnose the underlying causes of a brief loss of consciousness.

Nursing care, around the clock. The special needs of cardiac patients are the main reason why these two vital patient care areas are staffed with highly-trained, experienced Registered Nurses, master’s degree-prepared Nurse Practitioners (NPs), and Registered and Certified Physician Assistants (RPA-Cs), who provide care 24-hours-a-day, seven days per week. Many clinicians have earned advanced certification in critical care.

All nurses on the telemetry units are required to obtain certification in Advanced Cardiac Life Support. The Patient Care Associates (PCAs) have undergone an extra EKG training course, to learn how to monitor and interpret EKG rhythm strips. These additional skills enable PCAs to alert the nursing staff immediately of any sudden changes in a patient’s EKG.

Bindu Patel, Patient Care Associate (R), reads the cardiac monitors under the supervision of Eileen Gandolfo, CCRN (L), a telemetry staff nurse who is credentialed in critical care nursing.

How does telemetry work? Winthrop’s telemetry system is based on a series of radio monitors, installed in both units, and throughout the adjacent hallways. The patient slips a transmitter box into a pocket. It accurately monitors the heart’s rhythms, which are transferred to a central video monitor screen at the nursing station. There, the results are read, moment by moment, around the clock, by the nursing staff. As many telemetry patients are well enough to walk, they are encouraged to ambulate in the halls, which are wired to transmit their heart rhythms back to the central monitors. The Hospital’s entire second floor, which also houses the Radiology Department, is similarly wired, to enable uninterrupted monitoring, even while walking or being wheeled to Radiology. Telemetry enables cardiologists to pinpoint the moment that a heartbeat changed, and determine when and how the heart reacted to the start-up or change of medications, ambulation and activity, or to interventions or surgery.

Teamwork yields excellence. The effort, dedication, teamwork, and compassion that characterize the entire Nursing staff at Winthrop are very much in evidence on the telemetry units. For further information about Winthrop’s Institute for Heart Care, call 1-800-443-2788.

The Cardiac Rehabilitation Program, part of Winthrop’s Institute for Heart Care, has been awarded Program Certification by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). Certification recognizes only those programs rigorously reviewed by a national board and found to meet the essential requirements for standards of care. Based at 120 Mineola Boulevard, Mineola, the Cardiac Rehabilitation Program offers patient education, support groups, guest speakers, and yoga classes with a certified instructor. A few members of the Cardiac Rehabilitation Program’s clinical team display the AACVPR certification. L-R: Mary Anne Stecher, RN, C, Cardiac Rehabilitation Nurse; Dianna Scaccia, MS, Program Director; Gregory Macina, MD, Medical Director; and Fatima Hanlon, Medical Assistant. For further information on Winthrop’s Cardiac Rehabilitation Program, contact Ms. Scaccia at (516) 663-2599.

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