Exercise testing and portable ECG recording in arrhythmia-prone patients

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Transient arrhythmias and conduction disturbances can cause symptoms like palpitations, syncope, and dizziness.
• Patients with coronary heart disease or resting electrocardiogram (ECG) abnormalities are at higher risk.

Purpose of the Study:

• To compare the diagnostic yield of submaximal treadmill exercise testing and portable Holter monitoring for detecting transient arrhythmias.
• To evaluate the utility of these methods in ambulatory patients with suspected rhythm or conduction disturbances.

Main Methods:

• 200 patients with relevant symptoms or ECG findings underwent both submaximal treadmill exercise and 24-hour Holter monitoring.
• Arrhythmias and conduction disturbances were analyzed from resting 12-lead ECG, treadmill tests, and Holter recordings.

Main Results:

• 68% of patients showed arrhythmias on either treadmill or Holter, or both.
• Holter recording identified rhythm or conduction disturbances in 61.5% of patients, while exercise testing showed arrhythmias in 44.5%.
• Holter monitoring alone detected arrhythmias in 34% of patients, compared to 11% detected by treadmill exercise alone.

Conclusions:

• Holter recording is more effective than exercise testing for detecting transient arrhythmias.
• Both exercise testing and Holter monitoring are useful and complementary diagnostic tools for ambulatory patients with suspected rhythm or conduction disturbances.