[Non-invasive diagnosis of tachycardial heart arrhythmias]

The exact recognition of arrhythmias (AR) is the basis for decision making weather to treat AR or not. During the past the field of non-invasive, diagnostic tools approached from a simple 12-lead-routine ECG to higher sophisticated methods. This paper deals with the advantages and disadvantages of those non-invasive methods for AR-detection. Exercise Stress Tests (ET) are of value for the detection of "exercise induced" ventricular arrhythmias and tachycardias frequently related to ischaemia or cardiac congestion. ECG-Telemetry recognizes AR during the postinfarction-period during moderate exercise. The transmission of the ECG via the public telephone net (ECG-Telephone-Telemetry) is used in symptomatic patients possibly related to AR. With the ECG-TTM AR can be excluded in one third and in another third confirmed as cause for the symptoms. The Long-term ECG recording (Holter Monitoring) is today a frequently used method in the daily routine to detect AR and to control therapeutic effects. To avoid misinterpretations of the analysis-results we should be familiar with the system used and we have to look with criticism on the results presented by a machine. A new method, the registration of Late Potentials using the averaging technique of a high amplified ECG seems to be promising for risk-stratification: Patients with such Late-Potentials develop frequently ventricular tachycardia or die suddenly. Prior the use of invasive diagnostic methods or therapeutic interventions it is possible to recognize AR with the above mentioned complementary methods successfully.