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Ambulatory electrocardiography: an open-access service for general practitioners
The British Journal of Clinical Practice
|August 1, 1989
Summary
Ambulatory electrocardiography in primary care is effective for investigating cardiac symptoms. However, focusing on patients over 50 may improve cost-effectiveness, as younger patients rarely have significant arrhythmias.
Area of Science:
- Cardiology
- Primary Care Medicine
- Diagnostic Technology
Background:
- General practitioners (GPs) can investigate cardiac symptoms without hospital referral using ambulatory electrocardiography.
- A pilot open-access ambulatory electrocardiography service was established in three health centers.
Purpose of the Study:
- To analyze the results of a pilot open-access ambulatory electrocardiography service.
- To evaluate the utility of ambulatory monitoring for patients with cardiac symptoms in primary care.
Main Methods:
- Analysis of 200 consecutive patients referred to the service.
- Data collected from 22 GPs over a period of time.
- Stratification of results by age (<50 years vs. >50 years).
Main Results:
- In patients under 50, significant arrhythmias were rare (3/72), with only one requiring treatment.
- In patients over 50, 13% (16/128) showed major significant arrhythmias, and two pacemakers were implanted.
- Palpitations and dizziness were common (39%) but did not correlate with significant arrhythmias in either age group.
Conclusions:
- Ambulatory electrocardiography is a valuable tool for GPs in managing cardiac symptoms.
- The symptom of palpitation/dizziness in primary care is infrequently caused by significant arrhythmias.
- Restricting ambulatory monitoring to patients over 50, or those with other cardiac disease indicators, could enhance service cost-effectiveness.