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[Ambulatory electrocardiography in aged patients with syncope]
A Di Biase1, S Di Benedetto, E Labriola
1Università di Bologna, Istituto di 1a Clinica Medica.
Minerva Medica
|June 1, 1989
Summary
Dynamic ECG is not very useful for diagnosing syncope, especially in older adults. While arrhythmias increase with age, they often don't correlate with symptoms during monitoring.
Area of Science:
- Cardiology
- Geriatrics
- Diagnostic Medicine
Background:
- Syncope (fainting) is a common clinical problem, particularly in the elderly.
- Dynamic electrocardiogram (ECG) monitoring is frequently used to investigate the cause of syncope.
- The correlation between reported symptoms and ECG findings in syncope patients is not well established.
Purpose of the Study:
- To evaluate the diagnostic utility of dynamic ECG in patients presenting with syncope or near-syncope.
- To assess the incidence of arrhythmias during dynamic ECG monitoring in this patient group.
- To determine the relationship between symptoms, arrhythmias, and age.
Main Methods:
- A retrospective analysis of 3600 dynamic ECG recordings performed over seven years.
- Identification of patients investigated for syncopal or equivalent episodes.
- Correlation of recorded symptoms with ECG findings, specifically arrhythmias.
Main Results:
- 11.3% of recordings were for syncope; 9% of patients experienced symptoms during monitoring.
- Only 2.9% of patients had symptoms that corresponded to a detected arrhythmia.
- Both atrial and ventricular arrhythmias showed an increasing incidence with advancing age.
Conclusions:
- Dynamic ECG has limited diagnostic value for syncope, especially in the elderly.
- The poor correlation between symptoms and significant arrhythmias reduces its utility.
- Age-related increases in arrhythmias do not necessarily explain syncopal episodes detected by dynamic ECG.