OBJECTIVE: We studied the optimal duration of ambulatory event monitors for symptomatic patients and the predictors of detected events. METHODS: Patients with palpitations or dizziness received a patient-activated handheld event monitor which records 30 s single-lead ECG strips. Patients were monitored in an ambulatory setting for a range of 1-4 weeks and ECG strips interpreted by five independent electrophysiologists. Event pick-up rates and clinical covariates were analysed. RESULTS: Of 335 consecutive adults (age 50±16 years, 58% female) with palpitations (94%) and dizziness (25%) monitored, 286 patients (85%) reported events, and clinically significant events were detected in 86 (26%) patients. Of these 86 patients, 26% had ≥2 significant events, and 73% had events detected in the first 3 days. No significant events were detected after 12 days. The most common ECG abnormalities detected were premature ventricular ectopy (38%), premature atrial ectopy (37%) and atrial fibrillation (AF)/atrial flutter (34%). A history of AF (adjusted OR (AOR) 4.2, 95% CI 1.1 to 15.8), previous arrhythmia (AOR 2.8, 95% CI 2.3 to 5.9) and previous abnormal ambulatory monitoring (AOR 3.4, 95% CI 1.0 to 9.4) were associated with detection of clinically significant events. Patients older than 50 years were 82% more likely to have a clinically significant event (OR 1.8, 95% CI 1.3 to 3.6). CONCLUSION: Patient-activated ambulatory event monitoring for 7 days may be sufficient in the diagnosis of symptomatic patients as significant events first detected beyond 10 days were rare. Patients with a history of AF, arrhythmia or previous abnormal ambulatory monitoring may require even shorter monitoring periods.
OBJECTIVE: We studied the optimal duration of ambulatory event monitors for symptomatic patients and the predictors of detected events. METHODS: Patients with palpitations or dizziness received a patient-activated handheld event monitor which records 30 s single-lead ECG strips. Patients were monitored in an ambulatory setting for a range of 1-4 weeks and ECG strips interpreted by five independent electrophysiologists. Event pick-up rates and clinical covariates were analysed. RESULTS: Of 335 consecutive adults (age 50±16 years, 58% female) with palpitations (94%) and dizziness (25%) monitored, 286 patients (85%) reported events, and clinically significant events were detected in 86 (26%) patients. Of these 86 patients, 26% had ≥2 significant events, and 73% had events detected in the first 3 days. No significant events were detected after 12 days. The most common ECG abnormalities detected were premature ventricular ectopy (38%), premature atrial ectopy (37%) and atrial fibrillation (AF)/atrial flutter (34%). A history of AF (adjusted OR (AOR) 4.2, 95% CI 1.1 to 15.8), previous arrhythmia (AOR 2.8, 95% CI 2.3 to 5.9) and previous abnormal ambulatory monitoring (AOR 3.4, 95% CI 1.0 to 9.4) were associated with detection of clinically significant events. Patients older than 50 years were 82% more likely to have a clinically significant event (OR 1.8, 95% CI 1.3 to 3.6). CONCLUSION: Patient-activated ambulatory event monitoring for 7 days may be sufficient in the diagnosis of symptomatic patients as significant events first detected beyond 10 days were rare. Patients with a history of AF, arrhythmia or previous abnormal ambulatory monitoring may require even shorter monitoring periods.
Authors: Emmy Hoefman; Henk C P M van Weert; Johannes B Reitsma; Rudolph W Koster; Patrick J E Bindels Journal: Fam Pract Date: 2005-06-17 Impact factor: 2.267
Authors: Emmy Hoefman; Henk C P M van Weert; Kimberly R Boer; Johannes Reitsma; Rudolph W Koster; Patrick J E Bindels Journal: Fam Pract Date: 2006-12-07 Impact factor: 2.267
Authors: Steven A Rothman; James C Laughlin; Jonathan Seltzer; Jasjit S Walia; Rakesh I Baman; Samer Y Siouffi; Robert M Sangrigoli; Peter R Kowey Journal: J Cardiovasc Electrophysiol Date: 2007-03
Authors: Soori Sivakumaran; Andrew D Krahn; George J Klein; Jane Finan; Raymond Yee; Suzanne Renner; Allan C Skanes Journal: Am J Med Date: 2003-07 Impact factor: 4.965
Authors: Gerrit Kaleschke; Boris Hoffmann; Imke Drewitz; Gerhard Steinbeck; Michael Naebauer; Andreas Goette; Günter Breithardt; Paulus Kirchhof Journal: Europace Date: 2009-10 Impact factor: 5.214