Comparison of 24 versus 12 hours of ambulatory ECG monitoring.

In order to assess the additional information obtained from 24 hours compared to 12 hours of ambulatory ECG (electrocardiogram) recording, we analyzed 72 ambulatory ECG monitoring tapes in which arrhythmias were present. In all cases the second 12 hours included the entire period of sleep. Only 38 of 233 (16 percent) episodes of arrhythmias, frequent premature ventricular contractions (PVC's), two or more PVC's in a row, multiform PVC's, ventricular bigeminy, trigeminy, premature atrial contractions (PAC's), and supraventricular tachyarrhythmias occurred for the first time in the second 12-hour period. New ventricular arrhythmias were detected during the second 12-hour period in 13 percent of the arrhythmic episodes. Although sleep resulted in a marked decrease in PVC frequency in 63 percent of 30 recordings, with frequent PVC's while awake, 8 percent had a significant increase during sleep. In contrast, short runs of supraventricular tachyarrhythmias occurred during the second 12 hours in 48 percent of cases, 66 percent of these while asleep. These data suggest that a 24-hour ambulatory ECG tape recording be utilized initially to characterize the occurrence and frquency of the patients' ambulatory arrhythmias during awake and sleep periods. Thereafter, additional ECG recordings for monitoring antiarrhythmic drug therapy can be accomplished with a 12-hour recording in more than 80 percent of patients