[Event recorder for etiological evaluation of sporadically occurring cardiovascular complaints and symptoms]

Rarely and transient occurring arrhythmia, palpitation, dizziness, syncopes and chest pain frequently cause symptoms and complaints to patients with congenital cardiac defects. The reliable identification of their pathogenesis is often difficult. The study presented here demonstrates the impact of an event recorder for enlightening sporadically occurring complaints and symptoms. Fifty patients (age between 11 and 70 years, median 27 years) were examined with an event recorder (King of Hearts Express, Instromedix, Hillsboro, USA). The patients were referred to an outpatient clinic for congenital cardiac defects in order to clarify unexplained arrhythmia, palpitations, dizziness, or syncope. Included were patients above 10 years of age. Previous cardiac studies (including ECG, exercise-ECG, Holter-Monitoring) were non-diagnostic in all. Altogether 227 ECGs had been recorded. 95% of them were of diagnostic quality. The event recorder afforded ambulatory monitoring and the median duration of monitoring was 22.5 days. The average number of registered events was 4.5 +/- 3.8. In 24% of the patients (n = 12) diagnostic and/or therapeutical consequences resulted: electrophysiological examination (n = 5), drug treatment (n = 4) and pacemaker implantation (n = 3). The event recorder is an important and highly effective tool in diagnosing sporadical transient symptoms and complaints, especially arrhythmias.