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The clinical impact of long-term ECG recording. A retrospective study of 150 patients
Insights
Long-term ECG (LECG) monitoring significantly impacted patient management in 46% of cases. This diagnostic tool guided treatments like pacemakers and antiarrhythmic drugs, or ruled out cardiac causes for symptoms.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Long-term electrocardiogram (LECG) recording is a diagnostic tool used in cardiology.
- Assessing the impact of LECG on clinical decision-making is crucial for understanding its utility.
Purpose of the Study:
- To evaluate how long-term ECG (LECG) recording influenced patient management by referring physicians.
- To determine the proportion of cases where LECG findings altered clinical decisions.
Main Methods:
- A retrospective study of 150 patients undergoing LECG monitoring for 12 hours or more.
- Analysis of referring physicians' records 12 months post-monitoring to assess management changes.
Main Results:
- LECG directly led to pacemaker implantation in 17 patients and antiarrhythmic drug prescription in 13 patients.
- In 17 patients, symptoms without arrhythmia on LECG allowed ruling out cardiac causes.
- Valuable clinical information, unobtainable by other methods, was provided by LECG in 9 cases.
- Overall, LECG affected patient management in 69 cases (46%).
Conclusions:
- Long-term ECG recording significantly influences clinical management in a substantial proportion of patients.
- LECG provides critical diagnostic information, aiding in treatment decisions and exclusion of cardiac etiologies for symptoms.
Abstract:
One-hundred and fifty patients referred for long-term ECG (LECG) recording at a university hospital were monitored for 12 hours or more. The referring physicians' patient records were studied 12 months or more after monitoring in an attempt to establish if and how LECG had affected patient management. Seventeen patients were treated with permanent pacemakers and 13 with antiarrhythmic drugs as a direct result of LECG. Thirteen patients who experienced symptoms with concomitant cardiac arrhythmia at the time of recording were considered not to require treatment. In 17 patients who experienced symptoms without concomitant arrhythmia during monitoring, cardiac arrhythmia could be ruled out as the cause of the symptoms. In 9 more patients, LECG was considered to have contributed "valuable clinical information" (which could not be obtained by other diagnostic methods) to the referring physician. Thus, LECG was considered to have affected the referring physician's management of the patients in 69 cases (46%).