Utility of an automatic and patient-triggered cardiac event recorder: experience in children

This study aimed to evaluate the diagnostic yield of an event recorder capable of automatic and manual recording in children with possible arrhythmia related symptoms.

We evaluated retrospectively 81 children monitored with Novacor event recorder system between September 2021 and September 2024. All of the patients performed 12-lead electrocardiogram (ECG), 24-hour-Holter monitoring, and echocardiography before the cardiac event recording.

Indications for cardiac event recorder monitoring were palpitations in 59 (72.8%) patients, chest pain and palpitations in 19 (23.5%) patients, and palpitations and presyncope in 3 (3.7%) patients. After a mean monitoring period of 14.40 ± 7.79 days, 65 (80%) children described symptoms and 41(63%) children had automatically or manually recorded arrhythmias. 63% of these arrhythmias were correlated with the symptoms. Of the 16 (19,8%) patients who were asymptomatic during the enrollment period, 9 (56%) had arrhythmia recorded with automatic arrhythmia detection property only. A total of 107 arrhythmias episodes were registered; forty-six (43%) episodes were patient triggered, and 61 (57%) were automatically recorded. While 24-hour-Holter monitoring detected a clinical diagnosis in 13 patients (16.7%), event recorder diagnosed clinical arrhythmia in 41 children (63%). Based on the event recorder and findings, 10 (12,3%) patients received an electrophysiology study/ablation.

We found that the automatic mode of the device provided additional clinical and therapeutic consequences. For this reason, a cardiac event recorder capable of automatically and manually recording may be a more preferable method in children with potentially arrhythmia related symptoms. Studies with larger patient series may provide illuminating data in this area.