Transtelephonic monitoring: documentation of transient cardiac rhythm disturbances

Symptoms suggestive of a transient disturbance in cardiac rhythm often prompt a patient to seek medical help. Transtelephonic monitoring (TTM) can document the rhythm at the exact time that the patient is experiencing clinical symptoms. Our experience with TTM from 1979 to 1983 involved 526 patients who had one or more of the following symptoms: near-syncope (in 121), light-headedness (in 248), intermittent palpitations (in 281), and tachycardia (in 321). Patients suspected of having a life-threatening arrhythmia after the initial history, physical examination, and laboratory testing were excluded from this study. Of the 526 patients, 259 transmitted with the TTM device during a typical symptomatic episode; 186 had an arrhythmia identified, and 73 had a normal cardiac rhythm. The mean duration (+/- SD) from receipt of the TTM system until the first transmission was 48 +/- 80 days. The most frequent diagnoses at transmission were supraventricular tachycardia (in 80 patients) and sinus tachycardia (in 46). This study showed that TTM is effective in documenting infrequent arrhythmias and in establishing the temporal relationship between clinical symptoms and the patient's heart rhythm. TTM is a useful, practical, and efficient addition to more conventional means of electrocardiographic monitoring for patients with non-life-threatening arrhythmias.