Abstract
This brief review is focused on 12-lead Holter electrocardiogram (ECG) recording including a review of the literature and the description of the advantages of its application. The standard 12-lead ECG provides a bedside snapshot of the electrical activity of the heart including vector information, but a snapshot of a few beats for some seconds might miss the whole story. Traditional Holter ECG displaying two or three leads may record all heart beats during a prolonged period, but the limited vector information might be a cause of shortcomings in the ECG diagnosis. The 12-lead Holter ECG overcomes these disadvantages and should be preferred for detecting episodes of arrhythmias, localize their origin or the localization of myocardial ischemia. The 12-lead Holter ECG monitoring is efficient in the evaluation of the effect of drugs or interventional therapeutic procedures, i.e., efficiency of biventricular pacing in patients with heart failure and permanent atrial fibrillation (AF). The automatic analysis of parameters in 12-lead Holter ECG is also providing information for risk stratification. In order to obtain a precise diagnosis based on the criteria established on standard ECG, the “real” 12-lead ECG with ten electrodes is advocated.
Zusammenfassung
Dieser Artikel faßt die Literatur zum Thema 12-Kanal-Langzeit-EKG zusammen und beschreibt die Vorteile der Anwendung. Das 12-Kanal-Stand-EKG ermöglicht eine Momentaufnahme der elektrischen Aktivität des Herzens einschließlich der vektoriellen Information, aber ein zeitlich befristeter Schnappschuß repräsentiert die klinischen Probleme häufig nicht ausreichend. Das traditionelle Langzeit-EKG mit zwei oder drei Ableitungen zeichnet lückenlos den Herzrhythmus auf, Lokalisation einer Arrhythmie oder Ischämie lassen sich jedoch nicht zuordnen. Das 12-Kanal-Langzeit-EKG bietet diese Informationen und ist bei der Evaluation medikamentöser Therapien oder bei Überprüfung therapeutischer Interventionen, z. B. Effektivität biventrikulärer Stimulation bei Patienten mit permanentem Vorhofflimmern, zu bevorzugen. Darüber hinaus verbessert die automatische Analyse des 12-Kanal-Langzeit-EKG auch die Risikostratifizierung des plötzlichen Herztodes. Im Hinblick auf eine präzise Diagnose, etablierte EKG-Kriterien miteinbeziehend, ist dem mit 10 Elektroden abgeleiteten „echten“ 12-Kanal-EKG der Vorzug vor den mit weniger Elektroden abgeleiteten, errechneten Varianten zu geben.
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Su, L., Borov, S. & Zrenner, B. 12-lead Holter electrocardiography. Herzschr Elektrophys 24, 92–96 (2013). https://doi.org/10.1007/s00399-013-0268-4
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DOI: https://doi.org/10.1007/s00399-013-0268-4