Holter ECG and the evaluation of patient’s symptoms

  • H. Weber
  • H. Schmidinger
  • Ch. Auinger
  • J. Wolfram
  • T. Rimpfl
  • G. Norman
  • R. Schmid
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 92)


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’.


Mitral Valve Prolapse Holter Monitoring Mitral Valve Disease Holter Record Morphologic Substrate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • H. Weber
    • 1
  • H. Schmidinger
    • 1
  • Ch. Auinger
    • 1
  • J. Wolfram
    • 1
  • T. Rimpfl
    • 1
  • G. Norman
    • 1
  • R. Schmid
    • 1
  1. 1.Kardiologische Univ. KlinikViennaAustria

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