Comparison of the patient-activated event recording system vs. traditional 24 h Holter electrocardiography in individuals with paroxysmal palpitations or dizziness
Abstract
AIMS: Electrocardiographic documentation of symptomatic episodes of palpitations by means of traditional methods such as 24 h Holter monitoring (HM) or loop recorders is challenging. Patient-activated electrocardiography (ECG) recorders have been proved to be a useful tool in the diagnosis of arrhythmias in these patients. However, no comparison studies between the two techniques have been conducted. The aim of this study was to compare the diagnostic value of Holter ECG and a patient-activated event recorder (OMRON portable HeartScan ECG Monitor(®)) (HeartScan) in the detection of arrhythmias in patients with paroxysmal palpitations or dizziness suggestive of cardiac arrhythmias. METHODS AND RESULTS: Patients with paroxysmal palpitations or dizziness were eligible for this study. All patients underwent an HM for 24 h and a 15-day HeartScan after the HM. Six hundred and twenty-five patients (48% male, mean age: 37 ± 11 years) were included in the study. All patients present with normal heart structure, normal baseline 12-lead ECG, and normal echocardiogram. Indications for ECG monitoring were palpitations in 577 patients (92.3%) and dizziness in 48 (7.7%). Holter monitoring offered a clinical diagnosis in 11 patients (1.8%). Conversely, HeartScan diagnosed the clinical arrhythmia in 558 individuals (89%). Detection of symptoms-related arrhythmias by means of HeartScan was significantly higher when compared with HM (P < 0.01). CONCLUSION: The studied system proved to be an efficient event recorder providing the diagnosis of the clinical arrhythmia in 89% of patients with paroxysmal palpitations or dizziness. Further studies are needed to confirm our results.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In de Asmundis et al., Omron HeartScan detected significantly more symptom-related arrhythmias than Holter monitor (P < .01).
“A study by de Asmundis C et al17 revealed significantly higher detection of symptom‐related arrhythmias with Omron HeartScan compared with Holter monitor (P < .01).”
From Portable out-of-hospital electrocardiography: A review of current technologies (2018) · cites this paper as [17]
Cites
(1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-103-3-486_3 · Cited by 2,063 · see citing works
Robinson, R. (1993) · BMJ · doi:10.1136/bmj.307.6907.793 · Cited by 819 · 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 · see citing works
Incremental 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
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
A controlled clinical trial in 1809?
Milne, I., & Chalmers, I. (2002) · Journal of Epidemiology & Community Health · doi:10.1136/jech.56.1.1-a · Cited by 113 · 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
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
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
Scherr, D., Dalal, D., Henrikson, C. A., Spragg, D. D., Berger, R. D., Calkins, H., & Cheng, A. (2008) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-008-9251-0 · Cited by 45 · see citing works
Utility of patient-activated cardiac event recorders in the detection of cardiac arrhythmias
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. (2003) · Journal of Interventional Cardiac Electrophysiology · doi:10.1023/a:1023604816368 · Cited by 27 · 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
Self-citationNorman J. “Jeff” Holter–“Father” of Ambulatory ECG Monitoring
Barold, S. S. (2005) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-005-4787-8 · Cited by 21 · see citing works
Schuchert, A., Behrens, G., & Meinertz, T. (2002) · Zeitschrift für Kardiologie · doi:10.1007/s392-002-8373-4 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Priori, S. G., Blomström-Lundqvist, C., Mazzanti, A., Blom, N., Borggrefe, M., Camm, J., Elliott, P. M., Fitzsimons, D., Hatala, R., Hindricks, G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv316 · Cited by 3,893 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.054 · Cited by 1,883 · see citing works
Authors Task Force Members, Priori, S. G., Blomström‐Lundqvist, C., Mazzanti, A., Blom, N. A., Borggrefe, M., Camm, J. A., Elliot, P. M., Fitzsimons, D., Hatala, R., et al. (2015) · EP Europace · doi:10.1093/europace/euv319 · Cited by 1,667 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000549 · Cited by 750 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.10.035 · Cited by 730 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.053 · Cited by 686 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.10.036 · Cited by 639 · see citing works
Al-Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T., Field, M. E., Fonarow, G. C., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000548 · Cited by 412 · see citing works
Krittanawong, C., Rogers, A. J., Johnson, K. W., Wang, Z., Turakhia, M. P., Halperin, J. L., & Narayan, S. M. (2020) · Nature Reviews Cardiology · doi:10.1038/s41569-020-00445-9 · Cited by 237 · see citing works
Portable out-of-hospital electrocardiography: A review of current technologies
Bansal, A., & Joshi, R. (2018) · Journal of Arrhythmia · doi:10.1002/joa3.12035 · Cited by 174 · see citing works
Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines
Lebedev, D. S., Mikhaylov, E. N., Neminuschiy, N. M., Golukhova, E. Z., Babokin, V. E., Bereznitskaya, V. V., Vasichkina, E. S., Garkina, S. V., Sp, G., Davtyan, K. V., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4600 · Cited by 86 · see citing works
Frequent Ventricular Ectopy: Implications and Outcomes
Lee, A., Walters, T. E., Gerstenfeld, E. P., & Haqqani, H. M. (2018) · Heart Lung and Circulation · doi:10.1016/j.hlc.2018.09.009 · Cited by 29 · see citing works
Priori, S. G., Blomström‐Lundqvist, C., Mazzanti, A., Blom, N. A., Borggrefe, M., Camm, A. J., Elliot, P. M., Fitzsimons, D., Hatala, R., Hindricks, G., et al. (2016) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.recesp.2016.01.001 · Cited by 136 · see citing works
Cardiac monitoring for patients with palpitations
Pascual, J. F., Romero, J. C., Pérez‐Rodon, J., Benito, B., Santos‐Ortega, A., Maldonado, J., González, I. F., & Rivas‐Gándara, N. (2021) · World Journal of Cardiology · doi:10.4330/wjc.v13.i11.608 · Cited by 23 · see citing works
Gale, C. P., & Camm, A. J. (2016) · BMJ · doi:10.1136/bmj.h5649 · Cited by 21 · see citing works
A Review on Atrial Fibrillation Detection From Ambulatory ECG
Ma, C., Xiao, Z., Zhao, L., Biton, S. B., Behar, J. A., Long, X., Vullings, R., Aarts, R. M., Li, J., & Liu, C. (2023) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2023.3321792 · Cited by 20 · see citing works
External Cardiac Loop Recorders: Functionalities, Diagnostic Efficacy, Challenges and Opportunities
Rajanna, R. R., Sriraam, N., Prakash, V. S. R., Vittal, P. R., Arun, U., & Sahoo, S. (2021) · IEEE Reviews in Biomedical Engineering · doi:10.1109/rbme.2021.3055219 · Cited by 17 · see citing works
Determining the optimal duration for premature ventricular contraction monitoring
Hsia, B. C., Greige, N., Patel, S. K., Clark, R. M., Ferrick, K. J., Fisher, J. D., GROSS, J. N., Biase, L. D., & KRUMERMAN, A. K. (2020) · Heart Rhythm · doi:10.1016/j.hrthm.2020.07.013 · Cited by 15 · see citing works
Galectin-3: A Novel Biomarker Predicts Sudden Cardiac Death in Hypertrophic Cardiomyopathy
Emet, S., Dadashov, M., Sonsöz, M. R., Çakır, M. O., Yılmaz, M., Elitok, A., Bilge, A. K., Mercanoğlu, F., Öncül, A., Adalet, K., et al. (2018) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2018.08.013 · Cited by 15 · see citing works
Kułach, A., Dewerenda-Sikora, M., Majewski, M., Lasek‐Bal, A., & Gąsior, Z. (2020) · Open Medicine · doi:10.1515/med-2020-0203 · Cited by 15 · see citing works
Ambulatory cardiac bio-signals: From mirage to clinical reality through a decade of progress
Periyaswamy, T., & Balasubramanian, M. (2019) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2019.07.007 · Cited by 14 · see citing works
Advances in Cardiac Pacing: Arrhythmia Prediction, Prevention and Control Strategies
Patel, M. H., Sampath, S., Kapoor, A., Damani, D. N., Chellapuram, N., Challa, A. B., Kaur, M. P., Walton, R. D., Stavrakis, S., Arunachalam, S. P., et al. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.783241 · Cited by 14 · see citing works
Klein‐Wiele, O., Faghih, M., Dreesen, S., Urbien, R., Abdelghafor, M., Kara, K., Schulte-Hermes, M., Garmer, M., Grönemeyer, D. H. W., & Hailer, B. (2016) · Cardiology Journal · doi:10.5603/cj.a2016.0033 · Cited by 14 · 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
2025 Clinical practice guidelines for Ventricular arrhythmias of the heart and Sudden cardiac death
Mikhailov, E. N., Gizatulina, T. P., Lebedev, D. S., Golukhova, E. Z., Kharlap, M. S., Лебедева, В. К., Bagnenko, S. F., Artyukhina, Е. А., Babokin, V. E., Batalov, R. E., et al. (2026) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2025-6670 · Cited by 14 · see citing works
Velseboer, D. C., de Haan, R. J., Post, B., Krediet, C. T. P., Verberne, H. J., & de Bie, R. M. A. (2016) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.12415 · Cited by 11 · see citing works
Shen, Q., Li, J., Cui, C., Wang, X., Gao, H., Liu, C., & Chen, M. (2020) · Journal of Biomedical Research · doi:10.7555/jbr.34.20200074 · Cited by 11 · 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
Pascual, J. F., Santos‐Ortega, A., Roca‐Luque, I., Rivas‐Gándara, N., Pérez‐Rodon, J., Milà, L., David Garcia-dorado, A., & Moya‐Mitjans, À. (2018) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2018.04.007 · Cited by 12 · see citing works
Pascual, J. F., Santos‐Ortega, A., Roca‐Luque, I., Rivas‐Gándara, N., Pérez‐Rodon, J., Milà, L., David Garcia-dorado, A., & Moya‐Mitjans, À. (2018) · Revista Española de Cardiología · doi:10.1016/j.recesp.2018.04.013 · Cited by 9 · see citing works
A review of patient-led data acquisition for atrial fibrillation detection to prevent stroke
Kareem, M., Lei, N., Ali, A., Ciaccio, E. J., Acharya, U. R., & Faust, O. (2021) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2021.102818 · Cited by 10 · see citing works
Bray, J. J. H., Lloyd, E. F., Adenwalla, F., Kelly, S., Wareham, K., & Halcox, J. (2021) · BMJ Open Quality · doi:10.1136/bmjoq-2020-001270 · Cited by 8 · see citing works
Sp, G., Kostyukevich, M. V., Laiovich, L. I., Mironov, N. Y., Миронова, Н. А., Utsumueva, M. D., Khusyainova, D. R., Борисович, Ш. Н., Bazarov, B. C., Азизов, В. А., et al. (2022) · Eurasian heart journal · doi:10.38109/2225-1685-2022-4-6-67 · Cited by 10 · see citing works
Brembilla-Perrot, B., Sellal, J., Olivier, A., Villemin, T., Manenti, V., Brembilla, A., Rizk, J., de Chillou, C., Moulin-Zinsch, A., Marçon, F., et al. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.11.083 · Cited by 4 · see citing works
Steinberg, C., Bennett, M. T., & Krahn, A. D. (2017) · Cardiovascular medicine · doi:10.1007/978-3-319-58000-5_5 · Cited by 5 · see citing works
Screening for Atrial Fibrillation and the Role of Digital Health Technologies
Richardson, E., Hall, A., & Mitchell, A. R. J. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.88660 · Cited by 4 · see citing works
Mittal, S. (2015) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12322 · Cited by 4 · see citing works
GREGORIO, C. D., Franco, A. D., Panno, A. V., Franco, M. D., Scaccianoce, G., Campanella, F., Novo, G., Galassi, A. R., Novo, S., & The Safari Study Group (2023) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd10080336 · Cited by 3 · see citing works
Kułach, A., Kucio, M., Majewski, M., Gąsior, Z., & Smolka, G. A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14082649 · Cited by 3 · see citing works
Baptista, R., Maricoto, T., Monteiro, S. R., Dias, J., Gonçalves, S., Febra, H., & Gil, V. (2022) · Revista Portuguesa de Cardiologia · doi:10.1016/j.repc.2022.01.007 · Cited by 3 · see citing works
Brembilla-Perrot, B., Brembilla, A., Moulin-Zinsch, A., Sellal, J., Olivier, A., Manenti, V., Villemin, T., Lethor, J. P., Taihï, S., Rizk, J., et al. (2014) · Pediatric Cardiology · doi:10.1007/s00246-014-0965-8 · Cited by 3 · see citing works
Predicting Intermittent Atrial Fibrillation in Outpatient Clinics
Karaca, M., & Aytekin, D. (2017) · Korean Circulation Journal · doi:10.4070/kcj.2016.0340 · Cited by 1 · see citing works
2018 KHRS Guidelines for Catheter Ablation of Ventricular Arrhythmias – Part1
Roh, S., Kim, S., Kim, Y.-N., Kim, J.-Y., Kim, J., Kim, T., Nam, G., Park, K., Park, H., Pak, H., et al. (2018) · International Journal of Arrhythmia · doi:10.18501/arrhythmia.2018.006 · Cited by 1 · see citing works
Lucassen, W. A. M., Himmelreich, J. C. L., Harskamp, R. E., & Selder, J. L. (2021) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2620-4_30 · Cited by 1 · see citing works
Hendrikx, T. (2015) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 1 · see citing works
Use of a Patient-activated Event Recording System in a Patient with Infrequent Palpitations
Kwak, J.-J. (2015) · Arrhythmia · doi:10.18501/arrhythmia.2015.030
van Weert, H. C. P. M., & Peters, R. J. G. (2016) · Kernboek · doi:10.1007/978-90-368-1274-0_24
Ata, S. W. A. E., Elmasry, M. M., Shedoudy, S. A. A. E., & Nassar, M. B. (2024) · Cardiology and Angiology An International Journal · doi:10.9734/ca/2024/v13i1392
Himmelreich, J. C. L., Lucassen, W. A. M., & Harskamp, R. E. (2026) · doi:10.1007/978-90-368-3158-1_28
Utility of an automatic and patient-triggered cardiac event recorder: experience in children
Elkıran, Ö., & Öncül, M. (2026) · BMC Pediatrics · doi:10.1186/s12887-026-07447-5
Dzikowicz, D. J., Aktaş, M. K., Horn, R., MacKecknie, B. D., Cutter, K., Mykins, B., Cenname, K., McNitt, S. A., Couderc, J.-P. Y., Strawderman, R. L., et al. (2026) · JACC Advances · doi:10.1016/j.jacadv.2026.103102
- Authors
- de Asmundis, C., Conte, G., Sieira, J., Chierchia, G.-B., Rodriguez-Manero, M., Di Giovanni, G., Ciconte, G., Levinstein, M., Baltogiannis, G., Saitoh, Y., Casado-Arroyo, R., & Brugada, P.
- Affiliations
- Vrije Universiteit Brussel (BE)
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-02-26
- Volume
- 16
- Issue
- 8
- Pages
- 1231-1235
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2126686994
- Cited by
- 52
- References
- 14
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 4 · 2019: 2 · 2018: 7 · 2017: 7 · 2016: 7 · 2015: 7 · 2014: 1
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- Omron Healthcare
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- Holter monitoring, paroxysmal palpitations, dizziness, arrhythmia detection, arrhythmia diagnosis, diagnostic accuracy comparison
- MeSH terms
- Adult, Arrhythmias, Cardiac, Dizziness, Electrocardiography, Equipment Design, Female, Heart Rate, Humans, Male, Middle Aged, Predictive Value of Tests, Time Factors, Electrocardiography, Ambulatory, Catheter Ablation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review