The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
Recurrent Unexplained Palpitations (RUP) Study
Open accessAbstract
Objectives The aim of the study was to compare the diagnostic yield and the costs of implantable loop recorder (ILR) with those of the conventional strategy in patients with unexplained palpitations.Background In patients with unexplained palpitations, especially in those with infrequent symptoms, the conventional strategy, including short-term ambulatory electrocardiogram (ECG) monitoring and electrophysiological study, sometimes fails to establish a diagnosis.Methods We studied 50 patients with infrequent (< or =1 episode/month), sustained (>1 min) palpitations. Before enrollment, patients had a negative initial evaluation, including history, physical examination, and ECG. Patients were randomized either to conventional strategy (24-h Holter recording, a 4-week period of ambulatory ECG monitoring with an external recorder, and electrophysiological study) (n = 24) or to ILR implantation with 1-year monitoring (n = 26). Hospital costs of the 2 strategies were calculated.Results A diagnosis was obtained in 5 patients in the conventional strategy group, and in 19 subjects in the ILR group (21% vs. 73%, p < 0.001). Despite the higher initial cost, the cost per diagnosis in the ILR group was lower than in the conventional strategy group (euro 3,056 +/- euro 363 vs. euro 6,768 +/- euro 6,672, p = 0.012).Conclusions In subjects without severe heart disease and with infrequent palpitations, ILR is a safe and more cost-effective diagnostic approach than conventional strategy.
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“Moreover, clinical characteristics of the patient, such as age, presence of heart disease, and ECG abnormalities, do not always allow the physician to identify a priori those cases in which palpitations are caused by clinically significant rhythm disorders.8,47,48,52 -54”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [52]
In the citing paper
“Finally, a small percentage of patients with palpitations of unknown origin have major bradyarrhythmic disorders, such as severe sinus bradycardia and paroxysmal advanced atrioventricular block.52,71”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [52]
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Evaluation and outcomes of patients with palpitations
Weber, B. E., & Kapoor, W. N. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)89451-x · Cited by 196
Evaluation of patients with palpitations
Zimetbaum, P., & Josephson, M. E. (1998) · New England Journal of Medicine · doi:10.1056/nejm199805073381907 · Cited by 172
Cost implications of testing strategy in patients with syncope
Krahn, A. D., Klein, G. J., Yee, R., Hoch, J. S., & Skanes, A. C. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)00659-4 · Cited by 170
The Evolving Role of Ambulatory Arrhythmia Monitoring in General Clinical Practice
Zimetbaum, P. J., & Josephson, M. E. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-10-199905180-00020 · Cited by 139
Ermiş, C., Zhu, A. X., Pham, S., Li, J. M., Guerrero, M., Vrudney, A., Hiltner, L., Lü, F., Sakaguchi, S., Lurie, K. G., et al. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00889-0 · Cited by 50
Paroxysmal Tachycardia in Children and Teenagers with Normal Sinus Rhythm and Without Heart Disease
Brembilla-Perrot, B., Marçon, F., Bosser, G., Lucron, H., Houriez, P., Claudon, O., HOLBAN, I., & Blangy, H. (2001) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2001.00041.x · Cited by 23
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Kusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N. F., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.10.044 · Cited by 1,008
Kusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N. F., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000628 · Cited by 603
Indications for the use of diagnostic implantable and external ECG loop recorders
Task Force members, Brignole, M., Vardas, P., Hoffman, E., Huikuri, H., Moya, A., Ricci, R., Sulke, N., Wieling, W., EHRA Scientific Documents Committee, et al. (2009) · Europace · doi:10.1093/europace/eup097 · Cited by 362
Kusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N. F., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.10.043 · Cited by 337
Ambulatory Arrhythmia Monitoring: Choosing the Right Device
Zimetbaum, P., & Goldman, A. (2010) · Circulation · doi:10.1161/circulationaha.109.925610 · Cited by 209
Metadata
- Authors
- Giada, F., Gulizia, M., Francese, M., Croci, F., Santangelo, L., Santomauro, M., Occhetta, E., Menozzi, C., & Raviele, A.
- Affiliations
- Federico II University Hospital (IT)
- Azienda Ospedaliero Universitaria Maggiore della Carita (IT)
- Corresponding author
- Raviele, Antonio
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2007-05
- Volume
- 49
- Issue
- 19
- Pages
- 1951-1956
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W70889386
- Cited by
- 158
- References
- 9
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 9 · 2022: 9 · 2021: 15 · 2020: 6 · 2019: 7 · 2018: 16 · 2017: 11 · 2016: 7 · 2015: 10 · 2014: 11 · 2013: 13 · 2012: 5
- FWCI
- 5.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Funders
- Medtronic
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- implantable loop recorder, diagnostic yield, cost-effectiveness, Holter monitoring, electrophysiological study, arrhythmia diagnosis
- MeSH terms
- Adult, Aged, Arrhythmias, Cardiac, Cost-Benefit Analysis, Electrodes, Implanted, Female, Humans, Male, Middle Aged, Prospective Studies, Recurrence, Sensitivity and Specificity, Time Factors, Electrocardiography, Ambulatory
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