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Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias

BACKGROUND: Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a conveni...

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Autores principales: Hendrikx, Tijn, Rosenqvist, Mårten, Wester, Per, Sandström, Herbert, Hörnsten, Rolf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234325/
https://www.ncbi.nlm.nih.gov/pubmed/24690488
http://dx.doi.org/10.1186/1471-2261-14-41
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author Hendrikx, Tijn
Rosenqvist, Mårten
Wester, Per
Sandström, Herbert
Hörnsten, Rolf
author_facet Hendrikx, Tijn
Rosenqvist, Mårten
Wester, Per
Sandström, Herbert
Hörnsten, Rolf
author_sort Hendrikx, Tijn
collection PubMed
description BACKGROUND: Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a convenient and more sensitive alternative. The objective of this study is to compare the efficacy of 24-hour Holter ECG with intermittent short ECG recording over four weeks to detect relevant arrhythmias in patients with palpitations or dizziness/presyncope. METHODS: Design: prospective, observational, cross-sectional study. Setting: Clinical Physiology, University Hospital. Patients: 108 consecutive patients referred for ambiguous palpitations or dizziness/presyncope. Interventions: All individuals underwent a 24-hour Holter ECG and additionally registered 30-second handheld ECG (Zenicor EKG® thumb) recordings at home, twice daily and when having cardiac symptoms, during 28 days. Main outcome measures: Significant arrhythmias: atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), atrioventricular (AV) block II–III, sinus arrest (SA), wide complex tachycardia (WCT). RESULTS: 95 patients, 42 men and 53 women with a mean age of 54.1 years, completed registrations. Analysis of Holter registrations showed atrial fibrillation (AF) in two patients and atrioventricular (AV) block II in one patient (= 3.2% relevant arrhythmias [95% CI 1.1–8.9]). Intermittent handheld ECG detected nine patients with AF, three with paroxysmal supraventricular tachycardia (PSVT) and one with AV-block-II (= 13.7% relevant arrhythmias [95% CI 8.2–22.0]). There was a significant difference between the two methods in favour of intermittent ECG with regard to the ability to detect relevant arrhythmias (P = 0.0094). With Holter ECG, no symptoms were registered during any of the detected arrhythmias. With intermittent ECG, symptoms were registered during half of the arrhythmia episodes. CONCLUSIONS: Intermittent short ECG recording during four weeks is more effective in detecting AF and PSVT in patients with ambiguous symptoms arousing suspicions of arrhythmia than 24-hour Holter ECG.
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spelling pubmed-42343252014-11-18 Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias Hendrikx, Tijn Rosenqvist, Mårten Wester, Per Sandström, Herbert Hörnsten, Rolf BMC Cardiovasc Disord Research Article BACKGROUND: Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a convenient and more sensitive alternative. The objective of this study is to compare the efficacy of 24-hour Holter ECG with intermittent short ECG recording over four weeks to detect relevant arrhythmias in patients with palpitations or dizziness/presyncope. METHODS: Design: prospective, observational, cross-sectional study. Setting: Clinical Physiology, University Hospital. Patients: 108 consecutive patients referred for ambiguous palpitations or dizziness/presyncope. Interventions: All individuals underwent a 24-hour Holter ECG and additionally registered 30-second handheld ECG (Zenicor EKG® thumb) recordings at home, twice daily and when having cardiac symptoms, during 28 days. Main outcome measures: Significant arrhythmias: atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), atrioventricular (AV) block II–III, sinus arrest (SA), wide complex tachycardia (WCT). RESULTS: 95 patients, 42 men and 53 women with a mean age of 54.1 years, completed registrations. Analysis of Holter registrations showed atrial fibrillation (AF) in two patients and atrioventricular (AV) block II in one patient (= 3.2% relevant arrhythmias [95% CI 1.1–8.9]). Intermittent handheld ECG detected nine patients with AF, three with paroxysmal supraventricular tachycardia (PSVT) and one with AV-block-II (= 13.7% relevant arrhythmias [95% CI 8.2–22.0]). There was a significant difference between the two methods in favour of intermittent ECG with regard to the ability to detect relevant arrhythmias (P = 0.0094). With Holter ECG, no symptoms were registered during any of the detected arrhythmias. With intermittent ECG, symptoms were registered during half of the arrhythmia episodes. CONCLUSIONS: Intermittent short ECG recording during four weeks is more effective in detecting AF and PSVT in patients with ambiguous symptoms arousing suspicions of arrhythmia than 24-hour Holter ECG. BioMed Central 2014-04-01 /pmc/articles/PMC4234325/ /pubmed/24690488 http://dx.doi.org/10.1186/1471-2261-14-41 Text en Copyright © 2014 Hendrikx et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hendrikx, Tijn
Rosenqvist, Mårten
Wester, Per
Sandström, Herbert
Hörnsten, Rolf
Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
title Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
title_full Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
title_fullStr Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
title_full_unstemmed Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
title_short Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias
title_sort intermittent short ecg recording is more effective than 24-hour holter ecg in detection of arrhythmias
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234325/
https://www.ncbi.nlm.nih.gov/pubmed/24690488
http://dx.doi.org/10.1186/1471-2261-14-41
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