Wireless Holter transmission in suspected dysrhythmias

In patients with a history of possible dysrhythmias, documentation of an episode is mandatory before any form of treatment is given. Holter recordings with wireless telemetry offer the possibility of continuously recording electrocardiograms for days or even weeks with instantaneous analysis of the data in the physician's office.

Thirty-seven patients (20 male; median age, 8.4 years; range, 0.1-22 years), were investigated by using a telemetric Holter system (M120, Schiller, Switzerland), that is, intermittent transmission of the electrocardiographic data to a remote server using cell phone frequencies, with a median duration of the recordings of 6.5 days (range 1-42 days).

Recording quality was sufficient in all patients. Problems were related to electrode disconnections only, which were adjusted by contacting the patients. Twenty-eight of 37 recordings showed decisive findings. Of the 28 patients, no treatment was indicated in 16 patients, as subjective symptoms did not correlate with dysrhythmias; psychotherapy was indicated in 2 patients; antiarrhythmic medication was initiated or intensified in 5 patients; radiofrequency ablation was successfully performed in 5 patients; and 1 patient received an ICD. In 6 of 9 patients with negative Holter findings, a loop recorder implantation (Medtronic, Minneapolis, Minn) was indicated. In 1 patient, no dysrhythmias were recorded; however, when invasively investigated, ventricular tachycardia was detected and successfully treated by radiofrequency ablation. In 2 patients, no decision has been made to date.

Wireless Holter recordings are useful in detecting dysrhythmias with rare occurrence, are less expensive and less invasive compared with implantable loop recorders, and offer the patient rather wide geographic ranges with sufficient signal quality.