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

BMC Cardiovascular Disorders

Rolf Hörnsten¹  Herbert Sandström⁴  Per Wester²  Mårten Rosenqvist³  Tijn Hendrikx⁴ 

[1] Clinical Physiology, Heart Centre and Department of Surgical and Perioperative Science, Umeå University, SE-901 87 Umeå, Sweden;Umeå Stroke Center, Department of Public Health and Clinical Medicine, Umeå University, SE-90187 Umeå, Sweden;Department of Clinical Sciences, Danderyds Sjukhus, Karolinska Institutet, SE-182 88 Stockholm, Sweden;Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87 Umeå, Sweden

关键词: Intermittent ECG;    Holter ECG;    Electrocardiography;    Atrial fibrillation;    Arrhythmias;   

Others  :  855223
DOI  :  10.1186/1471-2261-14-41

 received in 2013-12-13, accepted in 2014-03-24,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Hendrikx et al.; licensee BioMed Central Ltd.

【 图 表 】

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