[Holter monitoring during sudden arrhythmic death]

Recordings of patients wearing a Holter monitor at the time of sudden cardiac death reveal that 16-20% of these patients die due to bradyarrhythmias. Tachyarrhythmic death is found in 80-84% of these patients. In about 40% lethal ventricular fibrillation is preceded by monomorphic ventricular tachyrcardias. in 20% by polymorphic ventricular tachycardias and torsades de pointes, respectively. Primary ventricular fibrillation is rare (3-5%). Typical "warning" arrhythmias, such as ventricular pairs or nonsustained ventricular tachycardias were found only inconsistently in the hours before death, as well as elevated heart rate. Thus it seems impossible at this time, to identify reliably those patients by telemetric ECG monitoring, who are at risk of imminent sudden arrhythmic death.