[Current limits of the long duration rhythmic holter: A real life study]
D Mlayeh1, F Monsel1, A Ben Amor2
1Unité de rythmologie, GHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France.
Insights
Long duration Holter ECG monitoring aids in diagnosing unexplained syncope and stroke by detecting arrhythmias. However, delays in device availability and follow-up appointments impact patient management and diagnosis.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Unexplained syncope and stroke often lack a definitive diagnosis.
- Long-duration Holter ECG monitoring is a valuable tool for diagnosing cardiac arrhythmias.
- Availability of Holter ECG recorders can be a limiting factor in clinical practice.
Purpose of the Study:
- To report single-center experience with long-duration Holter ECG in clinical practice.
- To evaluate its use in cardiology and neurology indications.
- To assess diagnostic delays associated with Holter ECG monitoring.
Main Methods:
- A Sorin Spiderflash device was used for 48 patients over six months.
- Patients were monitored for a mean duration of 10 days.
- Indications included stroke/TIA, palpitations, syncope, and arrhythmia management.
Main Results:
- Abnormalities were detected in 22% of patients, leading to treatment in 10%.
- Significant delays were observed: 39 days from event to indication, 32 days for device availability.
- Post-examination delays included 16 days for interpretation and 23 days for physician appointments.
Conclusions:
- Long-duration Holter ECG monitoring is useful for diagnosing arrhythmias in patients with unexplained symptoms.
- Significant delays in the diagnostic pathway, from indication to follow-up, require improvement.
- Optimizing the timing of Holter ECG exams, interpretation, and physician appointments can enhance patient management.
Background:
Syncope or stroke remain frequently without any explained diagnosis. Long duration holter ECG is an available tool to diagnose arrhythmias. However, this tool is subject to availability of the recorders.
Aim:
Report a single center experience with long duration holter ECG in clinical practice, in the different cardiology and neurology indications, and to assess the different delays until achievement of a diagnosis.
Methods And Results:
The device (Sorin Spiderflash) was used for 48 patients between January 2018 and June 2018. The holter was applied for a mean duration of 10±4days. The mean age was 55+19 years-old. 20 patients (42%) were explored for a stroke or transient ischemic attack (TIA), 18 (36%) for palpitations, 6 (12%) for syncope and 4 (8%) for evaluation of arrhythmias management. An abnormality has been recorded in 11 (22%) patients and a treatment has been administered in 5 patients (10%). Regarding, the timing of the exam, the mean time between the index event and the indication was 39 days. The mean time between the indication and the availability of the device was 32 days. 16 Days was the mean time for lecture and 23 days was the mean time between the result and the appointment with the cardiologist and neurologist.
Conclusion:
In this registry, the management of patients by non-invasive long duration holter ECG monitoring may be improved regarding the timing of the exams, their lecture and new appointments with the physicians.
Related Concept Videos
01:23Holter Monitor: 24-Hour Monitoring
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:30Dysrhythmias V: Evaluating Dysrhythmias
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:13Special considerations while measuring pulse