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Langzeit-Elektrokardiographie

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

In den vergangenen fast 50 Jahren hat sich das Langzeit-EKG zu einem etablierten nicht-invasiven elektrophysiologischen Verfahren entwickelt, das die laborunabhängige EKG-Aufzeichnung unter Alltagsbedingungen über einen längeren Zeitraum ermöglicht und dadurch eine Fülle von Informationen enthält. Während anfangs das Hauptinteresse vor allem Art und Häufigkeit von Arrhythmien sowie deren zirkadianes Auftreten und das zirkadiane Verhalten der Herzfrequenz galt, erweiterte sich das Spektrum der Analysemöglichkeiten im Zuge der technischen Entwicklung, so dass das Langzeit-EKG über die kontinuierliche ST-Streckenanalyse auch zur Diagnostik myokardialer Ischämien herangezogen wurde. Durch die Entwicklung digitaler Speichermedien und schneller Rechner mit großer Kapazität wurde die schlaggenaue Vermessung der Herzzyklen möglich, so dass über die Analyse der Herzfrequenzvariabilität neue Erkenntnisse über die autonome Modulation der Herzfrequenz und über die Vermessung des QT-Intervalls erstmals Einblicke in dessen zirkadianes Verhalten gewonnen werden konnten. Neben der quantitativen Analyse von Rhythmusstörungen wurde das Langzeit-EKG in zunehmendem Maße zur Beurteilung der Prognose bei zahlreichen kardialen Grunderkrankungen eingesetzt. Es findet außerdem Anwendung bei der Abklärung unklarer, vorübergehend auftretender Symptome sowie als Ergänzung der Diagnostik bei Verdacht auf Schrittmacher- oder ICD-Dysfunktionen, die nicht in jedem Falle durch die Kontrolle der Systeme aufgedeckt werden können.

Abstract

During the past almost 50 years Holter monitoring has become an established non-invasive diagnostic tool in clinical electrophysiology. It allows ECG recording independent of stationary monitoring facilities during daily life and, therefore, contains much information. In the beginning the main interest was directed towards quantitative and qualitative assessment of arrhythmias, their circadian behaviour, and the circadian behaviour of the heart rate. With advances in technology the analysis spectrum of Holter monitoring expanded, and it was used also for detection of silent myocardial ischaemia. New digital recorders and computers with large capacities made it possible to measure every single heart beat very accurately, which was a prerequisite for heart rate variability and QT-interval analysis, which provided new knowledge about the autonomic modulation of the heart rate and the circadian dynamicity of the QT interval, respectively. Beyond arrhythmia analysis Holter monitoring was increasingly used to assess prognosis in different cardiac conditions. It can also be valuable in assessing transient symptoms possibly related to arrhythmias or device dysfunction, which will not necessarily be revealed by simple device control.

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Authors and Affiliations

  1. Dept of Cardiology B, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark

    Axel Brandes

  2. Medizinische Klinik,, Friedrich-Ebert-Krankenhaus Lehrkrankenhaus der Universität Kiel, Friesenstraße 11, D-24534, Neumünster, Deutschland

    Klaus-Peter Bethge

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  1. Axel Brandes
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  2. Klaus-Peter Bethge
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Correspondence to Axel Brandes.

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Brandes, A., Bethge, KP. Langzeit-Elektrokardiographie. Herzschr. Elektrophys. 19, 107–129 (2008). https://doi.org/10.1007/s00399-008-0010-9

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