Is ambulatory electrocardiography a useful investigation in elderly people with 'funny turns'?

Episodic diffuse cerebral symptoms and unexpected falls were investigated by ambulatory electrocardiography in nine men and 19 women aged 65 years or more. Eight subjects with episodic dizziness or syncope had cardiac arrhythmias which are known to be capable of causing these symptoms and four of these had symptoms at the time of the arrhythmia. However, only one was detected by ambulatory electrocardiography alone. No significant arrhythmias were found in any of the remaining subjects. When 17 symptomatic subjects were compared with 17 age- and sex-matched asymptomatic controls, cardiac arrhythmias known to be capable of causing symptoms were commoner in the symptomatic group, but the differences were not statistically significant. Ambulatory electrocardiography is of no more value than standard electrocardiography in the detection of arrhythmias associated with diffuse cerebral symptoms in elderly people.