Abstract
Various symptoms can be correlated with ECG alterations (arrhythmias as well as ischemia). A simultaneous ECG registration during a symptomatic period excludes or confirms ECG alterations as cause of the symptoms. Otherwise symptoms can be probably related to arrhythmias or ischemia, if asymptomatic precursors of a specific symptom, e.g. syncope can be found in the ECG record.
The continuous recording of an ECG over a long period (24 hr and more) enhances the chance to correlate symptoms with the ECG.
Prior to Holter monitoring (HM) 63% of the patients (total 2420 HM) had a history of one (59%) or more (41%) symptoms. During one 24 hr HM only 20% developed a typical symptomatic period, 85% patients with a symptomatic history. In 60% (290/480 HM) arrhythmias could be excluded as underlying cause of the symptoms.
Palpitations prior to HM were reported in 17-31% of the patients. During HM about 56% of the symptomatic patients complained of palpitations, whereas in 37-47% arrhythmias could be related to the symptom.
Dizzy spells, presyncopes and syncopes were reported prior to HM in 25-53%, during HM in 56-65% of the symptomatic patients, whereas in 37-47% a morphologic substrate could be found in the Holter-ECG. Therefore in patients with SY precursing arrhythmias should be taken into account, which could be detected in 36-46%. Otherwise 40-54% of patients with SY had completely uneventful HM.
Angina prior to HM occurred in 13% among our patients. During HM 20% developed typical symptoms and ST-depression, whereas 67-80% of ST-alterations were ‘silent’.
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© 1989 Kluwer Academic Publishers
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Weber, H. et al. (1989). Holter ECG and the evaluation of patient’s symptoms. In: Hombach, V., Hilger, H.H., Kennedy, H.L. (eds) Electrocardiography and Cardiac Drug Therapy. Developments in Cardiovascular Medicine, vol 92. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1081-2_5
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DOI: https://doi.org/10.1007/978-94-009-1081-2_5
Publisher Name: Springer, Dordrecht
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