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Event-Rekorder

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Ereignis- bzw. Schleifenrekorder mit diskontinuierlicher EKG-Dokumentation ermöglichen, den Herzrhythmus über lange Zeit zu überwachen. Dadurch können sie bei Patienten, die an seltenen, kurzfristigen und selbst terminierenden Attacken leiden, ein EKG im Anfall aufzeichnen, um das Symptom mit dem Herzrhythmus im Anfalls-EKG zu korrelieren. Externe Ereignisrekorder mit intermittierender Überwachung d.h. mit im Gerät integrierten Elektroden sind für Patienten mit Palpitationen oder Herzrasen ohne Bewusstseinsverlust geeignet. Externe Ereignisrekorder mit kontinuierlicher Überwachung werden häufig nur für wenige Wochen vom Patienten toleriert und zeigten bei Patienten mit rezidivierenden Synkopen unklarer Genese einen begrenzten diagnostischen Gewinn; eine Sondergruppe sind Patienten mit häufigen Rezidivsynkopen innerhalb weniger Wochen. Kleine implantierbare Schleifenrekorder (ILR) mit einer Verwendbarkeitsdauer von einem Jahr überwachen permanent den Herzrhythmus und speichern nach Patienten- oder automatischer Aktivierung ein bipolar abgeleitetes 1-Kanal-EKG bis zu 42 Minuten vor der Aktivierung ab. Die diagnostische Überlegenheit des implantierbaren Ereignisrekorders gegenüber der bisherigen Standarddiagnostik wurde in randomisierten Studien belegt. Mit dem implantierbaren Ereignisrekorder lässt sich bei Patienten mit rezidivierenden Synkopen eine Rhythmusstörung am besten als Ursache der Synkope nachweisen bzw. ausschließen und ferner lassen sich solche Patienten identifizieren, die von einer Schrittmacherimplantation profitieren. Weitere mögliche Indikationen wie die Überwachung von Vorhofflimmern, die Diagnostik bei Palpitationen oder epileptischen Anfällen sind bei der technischen Weiterentwicklung des Geräts in der Zukunft abzusehen.

Abstract

Event or loop recorders monitor heart rhythm using discontinuous ECG storage which enables them to obtain a correlation between symptoms and the underlying heart rhythm in patients with infrequent, short-lasting episodes. External event recorders with intermittent monitoring, i.e., with electrodes within the device, are suitable for patients with palpitations or tachycardia who remain conscious. External event recorders with continuous monitoring are tolerated by patients for a few weeks and have a limited diagnostic impact in patients with recurrent syncope. The implantable loop recorder (ILR) monitors heart rhythm for one year and after patient-triggered or automatic activation stores a one-lead ECG up to 42 minutes prior to device activation. The diagnostic benefit of ILR in comparison to conventional approaches has been demonstrated in randomised studies. Furthermore, an ILR identifies patients with recurrent syncope of unknown origin in whom a pacemaker implantation can avoid further episodes. Additional possible indications are the monitoring of atrial fibrillation, the diagnostics of infrequent palpitations and patients with seizures.

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  1. Friedrich-Ebert-Krankenhaus, Medizinische Klinik, Friesenstr. 11, 24534, Neumünster, Deutschland

    Andreas Schuchert

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  1. Andreas Schuchert
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Correspondence to Andreas Schuchert.

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Schuchert, A. Event-Rekorder. Herzschr. Elektrophys. 19, 130–136 (2008). https://doi.org/10.1007/s00399-008-0011-8

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  • DOI: https://doi.org/10.1007/s00399-008-0011-8

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