| Diagnostic yield of automatic and patient-triggered ambulatory cardiac event recording in the evaluation of patients with palpitations, dizziness, or syncope. | |
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MedLine Citation:
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PMID: 12708623 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recent studies have shown that patient-triggered cardiac event recorders (CER) have an increased diagnostic yield and are more cost effective than conventional 24-h-Holter electrocardiograms (ECGs) for the evaluation of sporadic, potentially arrhythmia-related symptoms. HYPOTHESIS: The aim of this study was to determine the diagnostic yield of a patient-triggered CER combined with continuous automatic arrhythmia detection in the evaluation of sporadic dizziness/syncope or palpitations and its clinical relevance in assessing the further management. METHODS: We investigated 101 consecutive outpatients (54 +/- 20 years, 40 women), referred for evaluation of sporadic dizziness and syncope (36%) or palpitations (64%) of suspected rhythmogenic origin. All were monitored by patient-triggered CER with continuous automatic arrhythmia detection. RESULTS: After a mean monitoring period of 103 +/- 38 h, 83 patients registered symptoms and 57 patients had diagnostic or therapeutic relevant arrhythmias (relA). A total of 196 episodes of relA were recorded; 31 (16%) episodes were patient-triggered and 165 (84%) automatically recorded. Diagnostic relevant episodes (relA and/or typical symptoms) occurred in 94 patients, in 54% after the first 24 h of monitoring. According to the results of the CER, 80 patients needed no further diagnostic evaluation; 20 had additional diagnostic tests. CONCLUSIONS: Cardiac event recorders with a continuous automatic arrhythmia detection function are a well-tolerated device for sporadic, potentially arrhythmia-related symptoms. The patient-triggered mode alone is not sufficiently reliable; the automatic continuous arrhythmia detection function has additional diagnostic and therapeutic consequences. In 54% of all patients, the first diagnostic event would not have been recorded with a single conventional 24-h-Holter ECG. |
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Authors:
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Nicola Balmelli; Barbara Naegeli; Osmund Bertel |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 26 ISSN: 0160-9289 ISO Abbreviation: Clin Cardiol Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-23 Completed Date: 2003-07-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 173-6 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arrhythmias, Cardiac
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diagnosis* Dizziness / diagnosis* Electrocardiography / instrumentation Electrocardiography, Ambulatory Female Humans Male Middle Aged Monitoring, Ambulatory / instrumentation* Syncope / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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