Utility of patient-activated cardiac event recorders in the detection of cardiac arrhythmias
Abstract
Background Patient-activated event recorders are useful for the diagnosis of arrhythmia in patients with palpitation and presyncope. However, the utility of event recorders in patients suspected of arrhythmia but presenting with other symptoms is not clear. Furthermore, the factors influencing their utility have not been evaluated.Methods Event recorder reports of six hundred and sixty consecutive patients referred due to clinical suspicion of cardiac arrhythmia were reviewed. We divided symptoms into four groups: palpitation, presyncope, chest tightness, and dyspnea. We calculated the diagnostic yield according to patients' symptoms reported on the record, and analyzed the factors affecting the utility of event recorders.Results The overall diagnostic yield was 64%, and those of palpitation, presyncope, chest tightness, and dyspnea were 66%, 57%, 51% and 60%, respectively. The most common five findings in our patients were sinus rhythm (36%), sinus tachycardia (30%), atrial premature complex (14%), ventricular premature complex (12%), and atrial fibrillation/atrial flutter (7%). The recording duration (8 +/- 4 days) was short in the present study, but the overall diagnostic yield was similar to those of previous ones. Women had lower diagnostic yields than men, especially in atrial flutter-fibrillation. The diagnostic yield was not influenced by age, ordered doctors, or history of cardiovascular disease. CONCLUSIONS; Patient-activated event recorders provided a good diagnostic yield in patients with different presentations of cardiac arrhythmia, and women had lower diagnostic yield in atrial flutter-fibrillation.
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Clinically significant arrhythmias such as atrial fibrillation/flutter or paroxysmal supraventricular tachycardias are also a frequent finding in patients with palpitations.
“Nevertheless, clinically significant arrhythmias such as atrial fibrillation/flutter or paroxysmal supraventricular tachycardias are also a frequent finding.45,46”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [46]
Cites
Use of an Extended Monitoring Strategy in Patients With Problematic Syncope
Krahn, A. D., Klein, G. J., Yee, R., Takle-Newhouse, T., & Norris, C. (1999) · Circulation · doi:10.1161/01.cir.99.3.406 · Cited by 360 · see citing works
Shaw, L. J., Miller, D. D., Romeis, J. C., Kargl, D., Younis, L. T., & CHAITMAN, B. R. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-120-7-199404010-00005 · Cited by 350 · see citing works
Kinlay, S., Leitch, J. W., Neil, A., Chapman, B. L., Hardy, D. B., & Fletcher, P. J. (1996) · Annals of Internal Medicine · doi:10.7326/0003-4819-124-1_part_1-199601010-00003 · Cited by 245 · cited 1× · see citing works
“5% vs 11–18%) or ventricular tachycardia (1% vs 4%) was relatively low in our study [1,5,7].”
BackgroundIncremental diagnostic yield of loop electrocardiographic recorders in unexplained syncope
Linzer, M., Pritchett, E. L. C., Pontinen, M., McCarthy, E., & Divine, G. W. (1990) · The American Journal of Cardiology · doi:10.1016/0002-9149(90)90591-n · Cited by 239 · see citing works
Effects of Gender on Cardiac Arrhythmias
LARSEN, J. A., & Kadish, A. H. (1998) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1998.tb00950.x · Cited by 145 · see citing works
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 · see citing works
Zimetbaum, P. J., Kim, K. Y., Josephson, M. E., Goldberger, A. L., & Cohen, D. J. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-11-199806010-00002 · Cited by 133 · see citing works
Bhandari, A. K., Anderson, J. L., Gilbert, E. M., Alpert, B. L., Henthorn, R. W., Waldo, A. L., Cullen, M. T., Hawkinson, R. W., & Pritchett, E. L. C. (1992) · American Heart Journal · doi:10.1016/0002-8703(92)90601-q · Cited by 108 · see citing works
Utility and cost of event recorders in the diagnosis of palpitations, presyncope, and syncope
Fogel, R. I., Evans, J. J., & Prystowsky, E. N. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00717-5 · Cited by 83 · see citing works
Utility of Patient-Activated Cardiac Event Recorders in General Clinical Practice
Zimetbaum, P., Kim, K. Y., Ho, K. K. L., Zebede, J., Josephson, M. E., & Goldberger, A. L. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00766-7 · Cited by 77 · see citing works
A cost-effectiveness strategy for transtelephonic arrhythmia monitoring
Wu, J., Kessler, D. K., Chakko, S. C., & Kessler, K. M. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(00)80075-2 · Cited by 41 · see citing works
Comparison of the diagnostic yield of Holter versus transtelephonic monitoring.
Kuś, T., Nadeau, R. A., Costi, P., Molin, F., & Primeau, R. E. (1995) · PubMed · Cited by 26 · see citing works
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Sorted by citations
Relationship between atrial tachyarrhythmias and symptoms
Strickberger, S. A., Ip, J. E., Saksena, S. V., Curry, K., Bahnson, T. D., & Ziegler, P. (2005) · Heart Rhythm · doi:10.1016/j.hrthm.2004.10.042 · Cited by 198 · see citing works
Raviele, A., Giada, F., Bergfeldt, L., Blanc, J. J., Blomstrom-Lundqvist, C., Mont, L., Morgan, J. M., Raatikainen, M. J. P., Steinbeck, G., Viskin, S., et al. (2011) · Europace · doi:10.1093/europace/eur130 · Cited by 149 · see citing works
Kaleschke, G., Hoffmann, B., Drewitz, I., Steinbeck, G., Naebauer, M., Goette, A., Breithardt, G., & Kirchhof, P. (2009) · Europace · doi:10.1093/europace/eup262 · Cited by 81 · see citing works
Does this patient with palpitations have a cardiac arrhythmia?
Thavendiranathan, P. (2009) · JAMA · doi:10.1001/jama.2009.1673 · Cited by 75 · see citing works
Long-term continuous external electrocardiographic recording: a review
Enseleit, F., & Duru, F. (2006) · EP Europace · doi:10.1093/europace/euj054 · Cited by 56 · see citing works
de Asmundis, C., Conte, G., Sieira, J., Chierchia, G.-B., Rodriguez-Manero, M., Di Giovanni, G., Ciconte, G., Levinstein, M., Baltogiannis, G., Saitoh, Y., et al. (2014) · Europace · doi:10.1093/europace/eut411 · Cited by 52 · see citing works
Efficacy of diagnostic tools for detecting cardiac arrhythmias: systematic literature search
Hoefman, E., Bindels, P., & van Weert, H. C. P. M. (2010) · Netherlands Heart Journal · doi:10.1007/s12471-010-0831-0 · Cited by 50 · see citing works
Multi-purpose ECG telemetry system
Marouf, M., Vukomanović, G., Saranovac, L. V., & Bozic, M. (2017) · BioMedical Engineering OnLine · doi:10.1186/s12938-017-0371-6 · Cited by 27 · see citing works
Bu, Y., Hassan, M. F. U., & Lai, D. (2020) · IEEE Sensors Journal · doi:10.1109/jsen.2020.3001295 · Cited by 26 · see citing works
Park, M. H. K., de Asmundis, C., Chierchia, G., Sarkozy, A., Benatar, A. A., & Brugada, P. (2011) · EP Europace · doi:10.1093/europace/eur159 · Cited by 23 · see citing works
Sharma, A. N., & Baranchuk, A. M. (2021) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2021.04.003 · Cited by 20 · see citing works
ANCZYKOWSKI, J., Willems, S., Hoffmann, B. A., Meinertz, T., Blankenberg, S., & Patten, M. (2016) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.13025 · Cited by 12 · see citing works
Attanasio, P., Huemer, M., Loehr, L., Parwani, A. S., Boldt, L., Haverkamp, W., & Wutzler, A. (2015) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12301 · Cited by 11 · see citing works
Palpitations: a proper evaluation and approach to effective medical therapy
Pickett, C. C., & Zimetbaum, P. J. (2005) · Current Cardiology Reports · doi:10.1007/s11886-005-0090-7 · Cited by 9 · see citing works
Chi, Z., Liu, R., Li, Y., Wang, K., Shu, C., & Ding, L. (2017) · Journal of Chromatographic Science · doi:10.1093/chromsci/bmx049 · Cited by 4 · see citing works
Electrocardiographic Monitoring Strategies (Holter, Implantable Loop Recorder, in Between)
Nazzari, H., Halperin, L. F., & Krahn, A. D. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99770-9 · Cited by 3 · see citing works
Utility and problems of the cardiac loop event recorder
Tatsuta, A., Yamada, T., Obara, Y., Ichikawa, A., Hayashi, T., Kawashima, M., & Hagiwara, N. (2009) · Japanese Journal of Electrocardiology · doi:10.5105/jse.29.141 · Cited by 2 · see citing works
OBSOLETE: Electrocardiographic Monitoring Strategies (Holter, Implantable Loop Recorder, in Between)
Krahn, A. D. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99770-8 · Cited by 1 · see citing works
Kardiyak Olay Kaydedici ve Telemetri Sistemi için Yeni Bir Bileklik Tasarımı
BİLGİN, G., Oktay, M., & Bilgin, S. (2021) · Mehmet Akif Ersoy Üniversitesi Fen Bilimleri Enstitüsü Dergisi · doi:10.29048/makufebed.889637 · Cited by 1 · see citing works
Iliev, I. T., Jekova, I. I., Tabakov, S. D., Koshtikova, K. G., Runev, N. M., & Manov, Е. (2022) · Lecture notes in networks and systems · doi:10.1007/978-3-030-96638-6_33 · Cited by 1 · see citing works
Daoulah, A., Calton, R. K., Newman, D. M., Lashevsky, I., & Crystal, E. (2010) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/j.1447-0594.2010.00646.x · Cited by 1 · see citing works
イベントレコーダー(携帯型発作時心電図計)により不安定狭心症の診断にいたった1症例
淳, 鈴., 一寛, 清., 森絵里香, 恵, 杉., 剛史, 小., 黒須, 巧., 平野, 圭., 啓二郎, 中., 野池, 博., & 東丸, 貴. (2009) · 心臓 · doi:10.11281/shinzo.41.1347
Chirurgie bei tachykarden Rhythmusstörungen und Herzschrittmachertherapie
Scheid, H. H., & Gulbins, H. (2010) · Springer eBooks · doi:10.1007/978-3-540-79713-5_26
Pines, J. M., Carpenter, C. R., Raja, A. S., & Schuur, J. D. (2012) · Wiley eBooks · doi:10.1002/9781118482117.ch24
Ambulatory Electrocardiography
Rho, R. W., & Page, R. L. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-0285-9.00071-5
Electrocardiographic Monitoring and Wearables
Azab, M., & Cheung, C. C. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00058-3
- Authors
- Wu, C.-C., Hsieh, M.-H., Tai, C.-T., Chiang, C.-E., Yu, W.-C., Lin, Y.-K., Tsao, H.-M., Ding, P. Y.-A., & Chen, S.-A.
- Affiliations
- Taipei Veterans General Hospital (TW)
- Corresponding author
- Hsieh, Ming-Hsiung
- ORCID
- Wu, Chih-Cheng
- Venue
- Journal of Interventional Cardiac Electrophysiology
- Published
- 2003-04
- Volume
- 8
- Issue
- 2
- Pages
- 117-120
- ISSN
- 1383-875X (ISSN-L)
- 1572-8595
- OpenAlex
- W1522788271
- Cited by
- 27
- References
- 12
- Citations by year
- 2026: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 1 · 2012: 2
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Interventional Cardiac Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- cardiac arrhythmias, diagnostic yield, palpitations, presyncope, chest tightness, dyspnea, atrial fibrillation, atrial flutter, sinus tachycardia, premature atrial contractions, premature ventricular contractions, sex differences, recording duration
- MeSH terms
- Arrhythmias, Cardiac, Dyspnea, Female, Heart Rate, Humans, Male, Middle Aged, Sex Factors, Syncope, Electrocardiography, Ambulatory
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