Transtelephonic monitoring in pediatric patients with clinically suspected arrhythmias

Evaluation of patients with symptoms suggestive of cardiac arrhythmias is difficult using standard studies if the episodes are infrequent and have a short duration. Transtelephonic electrocardiographic recorders were provided for 41 patients with suspected arrhythmic episodes. None had previously documented arrhythmia. There were 18 males and 23 females (age range 14 months to 19 years; mean 10.9 years). The interval prior to a diagnostic transmission was 0.5 to 8 months (mean 2.5 months). Twenty-one of 41 patients (51%) provided transmissions during a typical episode, nine of which were abnormal. Paroxysmal supraventricular tachycardia was found in eight patients and unsuspected intermittent complete heart block in one patient. The remaining 12 patients had normal sinus rhythm. Twenty patients did not transmit because episodes either were too brief or did not recur. Transtelephonic monitoring was effective in the diagnosis of certain arrhythmias that are infrequent and short in duration. Normal transmitted electrocardiograms during a typical symptomatic episode excluded cardiac arrhythmias.