[Simple electrophysiologic examination of patients with palpitation or tachycardia]

Discomfort because of palpitation and tachycardia is a frequent phenomenon. Clinical practice for diagnosing tachycardia has a low sensitivity, and patients without a correct diagnosis are often not treated optimally.

Results from all 24-hour-ECGs taken at Telemark Hospital in the period 1.8.04-31.7.05 were reviewed. Indications and findings were retrieved from the hospital database. 252 of totally 614 ECGs were performed for the indications palpitation and tachycardia. 137 patients with an unclear diagnosis were offered a simple electrophysiologic examination with stimulation of the right atrium by a pacemaker electrode. 38 of these patients were included and underwent the examination. An additional 18 patients were referred to a simple electrophysiologic examination based on the same criteria.

24-hour-ECG provided a diagnosis for 29 patients with palpitation and tachycardia. A simple electrophysiologic examination uncovered reentry tachycardia in nine patients and paroxystic atrial flutter in three patients. A total of 56 electrophysiologic examinations were performed, uncovering 12 cases of tachycardia suitable for ablation. Two patients had to undergo DC-conversion, no other complication was observed.

A simplified electrophysiologic examination of this group of patients will uncover tachycardia suitable for ablation in approximately 20 % of the patients, and increase diagnostic yield of supraventricular tachycardia by 64 %.