Utility of Mobile Cardiac Outpatient Telemetry for the Diagnosis of Palpitations, Presyncope, Syncope, and the Assessment of Therapy Efficacy
Abstract
INTRODUCTION: Continuous mobile cardiac outpatient telemetry (MCOT) may have several advantages over traditional ambulatory monitoring systems in the diagnostic evaluation of symptoms such as palpitations, dizziness, and syncope. However, only limited published data are available showing its advantages. METHODS AND RESULTS: We reviewed the records of 122 consecutive patients evaluated using MCOT for palpitations, presyncope/syncope, or to monitor the efficacy of a specific antiarrhythmic therapy. Ten of 17 patients (59%) studied for presyncope/syncope had a diagnosis made with MCOT. Eight of these 17 patients had a previous negative evaluation for presyncope/syncope and five had an event correlated with the heart rhythm during the monitoring period. Nineteen patients monitored for palpitations or presyncope/syncope were asymptomatic during monitoring but had a prespecified arrhythmia detected. When MCOT was used as the first ambulatory monitoring system to evaluate palpitations (n = 18), 73% of patients correlated their symptoms with the underlying cardiac rhythm. Seven of 21 patients monitored for medication titration had dosage adjustments during outpatient monitoring. CONCLUSIONS: MCOT can detect asymptomatic clinically significant arrhythmias, and was especially useful to identify the cause of presyncope/syncope, even in patients with a previous negative workup. This outpatient monitoring system allows patients to undergo daily medication dose titration in the outpatient setting, thus avoiding hospitalization.
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External and implantable loop recorders, mobile cardiac outpatient telemetry, and pacemakers and ICDs can detect asymptomatic clinically significant arrhythmias automatically, without patient activation.
“The external and implantable loop recorders, mobile cardiac outpatient telemetry, and pacemakers and ICDs can detect asymptomatic clinically significant arrhythmias automatically (i.e. with no activation by the patient)”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [73]
External and implantable loop recorders, mobile cardiac outpatient telemetry, and pacemakers and ICDs provide a significantly higher yield than standard patient-activated loop recorders in patients with infrequent palpitations.
“and provide a significantly higher yield than standard patient-activated loop recorders in patients with infrequent palpitations.49,73 -79”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [73]
Cites
Page, R. L., Wilkinson, W. E., Clair, W. K., McCarthy, E. A., & Pritchett, E. L. (1994) · Circulation · doi:10.1161/01.cir.89.1.224 · Cited by 627 · 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
Sivakumaran, S., Krahn, A. D., Klein, G. J., Finan, J., Yee, R., Renner, S., & Skanes, A. C. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00233-x · Cited by 160 · see citing works
Vasamreddy, C. R., Dalal, D., Dong, J., Cheng, A., SPRAGG, D. D., Lamiy, S. Z., Meininger, G. R., Henrikson, C. A., Marine, J. E., Berger, R. D., et al. (2006) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00359.x · Cited by 156 · 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
Joshi, A. K., Kowey, P. R., Prystowsky, E. N., Benditt, D. G., Cannom, D. S., Pratt, C. M., McNamara, A., & Sangrigoli, R. M. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2004.12.015 · Cited by 110 · see citing works
Self-citationCorrelation of Symptoms to ECG Diagnosis Following Atrial Fibrillation Ablation
Klemm, H. U., Ventura, R., Rostock, T., Brandstrup, B., Risius, T., Meinertz, T., & Willems, S. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2005.00288.x · Cited by 99 · 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
Self-citationAssessment of Rhythm and Rate Control in Patients with Atrial Fibrillation
Prystowsky, E. N. (2006) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00580.x · Cited by 20 · see citing works
Self-citation
Flagged first, then by citations
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Sorted by citations
Gelder, I. C. V., Rienstra, M., Bunting, K. V., Casado-Arroyo, R., Caso, V., Crijns, H. J. G. M., Potter, T. J. R. D., Dwight, J., Guasti, L., Hanke, T., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae176 · Cited by 3,338 · see citing works
Barrett, P. M., Komatireddy, R., Haaser, S., Topol, S., Sheard, J., Encinas, J., Fought, A. J., & Topol, E. J. (2014) · The American Journal of Medicine · doi:10.1016/j.amjmed.2013.10.003 · Cited by 498 · see citing works
Remote Patient Monitoring via Non-Invasive Digital Technologies: A Systematic Review
Vegesna, A., Tran, M., Angelaccio, M., & Arcona, S. (2017) · Telemedicine and e-Health · doi:10.1089/tmj.2016.0051 · Cited by 404 · see citing works
How to use digital devices to detect and manage arrhythmias: an EHRA practical guide
Svennberg, E., Tjong, F., Goette, A., Akoum, N., Di Biase, L., Bordachar, P., Boriani, G., Burri, H., Conte, G., Deharo, J. C., et al. (2022) · Europace · doi:10.1093/europace/euac038 · Cited by 261 · 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
Sick sinus syndrome: a review.
Semelka, M., Gera, J., & Usman, S. (2013) · PubMed · Cited by 134 · see citing works
Smart Wearables for Cardiac Monitoring—Real-World Use beyond Atrial Fibrillation
Duncker, D., Ding, W. Y., Etheridge, S. P., Noseworthy, P. A., Veltmann, C., Yao, X., Bunch, T. J., & Gupta, D. (2021) · Sensors · doi:10.3390/s21072539 · Cited by 132 · see citing works
Preliminary results of a limited thoracotomy: new approach to treat atrial fibrillation
MCCLELLAND, J. H., DUKE, D., & REDDY, R. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2007.00977.x · Cited by 90 · 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
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
Understanding Atrial Fibrillation: The Signal Processing Contribution, Part II
Mainardi, L., Sörnmo, L., & Cerutti, S. (2008) · Synthesis lectures on biomedical engineering · doi:10.2200/s00153ed1v01y200809bme025 · Cited by 47 · see citing works
Study of arrhythmia prevalence in NUVANT Mobile Cardiac Telemetry system patients
Engel, J. M., Mehta, V., Fogoros, R. N., & Chavan, A. (2012) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2012.6346457 · Cited by 44 · see citing works
Utility of in-hospital cardiac remote telemetry in patients with unexplained syncope
Benezet-Mazuecos, J., Ibanez, B., Rubio, J. M., Navarro, F., Martin, E., Romero, J., & Farre, J. (2007) · Europace · doi:10.1093/europace/eum239 · Cited by 38 · see citing works
Clinical validation of a low-power and wearable ECG patch for long term full-disclosure monitoring
Torfs, T., Smeets, C. J. P. P., Geng, D., Berset, T., der Auwera, J. V., Vandervoort, P. M., & Grieten, L. (2014) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2014.08.012 · Cited by 33 · see citing works
Critical review of electrocardiography measurement systems and technology
Kalra, A. M., Lowe, A., & Al‐Jumaily, A. M. (2018) · Measurement Science and Technology · doi:10.1088/1361-6501/aaf2b7 · Cited by 27 · see citing works
Kim, J. Y., Oh, I., Lee, H., Lee, J. H., Cho, Y., Gil, Y., Jung, S., Kim, D. I., Shin, M. G., Yoo, J. Y., et al. (2023) · Journal of Arrhythmia · doi:10.1002/joa3.12865 · Cited by 26 · see citing works
Clinical Approach to Patients with Palpitations
Giada, F., & Raviele, A. (2018) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2018.02.010 · Cited by 21 · 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
ECG Signal Quality Assessments of a Small Bipolar Single-Lead Wearable Patch Sensor
Rajbhandary, P. L., Nallathambi, G., Selvaraj, N., Tran, T. V., & Colliou, O. K. (2022) · Cardiovascular Engineering and Technology · doi:10.1007/s13239-022-00617-3 · Cited by 19 · see citing works
Evidence-Based Approach to Palpitations
Weinstock, C., Wagner, H., Snuckel, M., & Katz, M. (2020) · Medical Clinics of North America · doi:10.1016/j.mcna.2020.09.004 · Cited by 19 · see citing works
Murali, S., Brugger, N., Rincón, F. J., Mashru, M. R., Cook, S., & Goy, J. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.587945 · Cited by 17 · see citing works
Sandberg, E. L., Grenne, B. L., Berge, T., Grimsmo, J., Atar, D., Halvorsen, S., Fensli, R. W., & Jortveit, J. (2021) · Journal of Healthcare Engineering · doi:10.1155/2021/5230947 · Cited by 15 · see citing works
Engel, J. M., Chakravarthy, N., Nosbush, G., Merkert, M., Fogoros, M. D. R., & Chavan, A. (2014) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2014.6944187 · Cited by 13 · see citing works
Clinical Data Privacy and Customization via Biometrics Based on ECG Signals
Silva, H., Lourenço, A., Fred, A. L. N., & Filipe, J. (2011) · Lecture notes in computer science · doi:10.1007/978-3-642-25364-5_12 · Cited by 12 · 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
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
Debatable issues in automated ECG reporting
Macfarlane, P. W., Mason, J. W., Kligfield, P., Sommargren, C. E., Drew, B. J., van Dam, P. M., Abächerli, R., Albert, D. J., & Hodges, M. (2017) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2017.08.027 · Cited by 10 · see citing works
How to use implantable loop recorders in clinical trials and hybrid therapy
Jung, W., Zvereva, V., Rillig, A., Roggenbuck, B., Sadeghzadeh, G., & Kohler, J. (2011) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-011-9611-z · Cited by 9 · see citing works
Gula, L. J., Klein, G. J., Zurawska, U., Massel, D. R., Yee, R. K., Skanes, A. C., & Krahn, A. D. (2009) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2009.02306.x · Cited by 7 · see citing works
Noncontact ECG system for unobtrusive long-term monitoring
McDonald, N. J., Anumula, H., Duff, E., & Soussou, W. (2012) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2012.6346254 · Cited by 6 · see citing works
Understanding Atrial Fibrillation: The Signal Processing Contribution, Part I
Mainardi, L. T., Sörnmo, L., & Cerutti, S. (2008) · Synthesis lectures on biomedical engineering · doi:10.2200/s00152ed1v01y200809bme024 · Cited by 5 · see citing works
Time–Frequency Analysis of Atrial Fibrillation
Sandberg, F., Stridh, M., & Sörnmo, L. (2008) · Synthesis lectures on biomedical engineering · doi:10.1007/978-3-031-01633-2_4 · Cited by 5 · see citing works
Bieganowska, K., Kaszuba, A., Bieganowski, M., & Kaczmarek, K. A. (2017) · Pediatric Cardiology · doi:10.1007/s00246-016-1534-0 · Cited by 4 · see citing works
Mohr, B. A., Wadhwa, M. K., Medić, G., Lavelle, J., Buchenberger, J. D., & Norlock, V. (2022) · Journal of Comparative Effectiveness Research · doi:10.2217/cer-2022-0112 · Cited by 3 · see citing works
Enfoque semiológico de las palpitaciones
Gaviria, M. Á., Bustos, C. H., & Mora, G. (2014) · Revista de la Facultad de Medicina · doi:10.15446/revfacmed.v62n1.43779 · Cited by 3 · see citing works
Oeff, M., Müller, A., Neuzner, J., Sack, S., SCHWAB, J. O., Pfeiffer, D., & Zugck, C. (2008) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-008-0012-7 · Cited by 3 · see citing works
Do all hospital inpatients need cardiac telemetry?
Baibars, M., Al‐Khadra, Y., Fanari, Z., Pacha, H. M., Soud, M., & Alraies, M. C. (2018) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.85a.17114 · Cited by 3 · 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
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
Smart IoT-Based Cardiac Devices for Ambulatory Healthcare Monitoring
Joy, S. I., Moorthi, M., & Kumar, K. S. (2024) · Lecture notes in networks and systems · doi:10.1007/978-981-97-5146-4_39 · Cited by 1 · see citing works
Krahn, A. D., Yee, R., Skanes, A. C., & Klein, G. J. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-44733-1.00066-3 · Cited by 1 · see citing works
Diagnosis of Arrhythmias with Non-invasive Tools
Sullivan, R. M., Li, W. W., Kendig, A. C., & Olshansky, B. (2010) · Humana Press eBooks · doi:10.1007/978-1-60761-161-5_5 · Cited by 1 · see citing works
Clinical Trials Landscape: What's New, What's Ongoing, What Do We Need
Brignole, M., Benditt, D. G., & Wieling, W. (2007) · Wiley eBooks · doi:10.1002/9780470692639.ch27
Outcome of Patients Discharged after their First Detected Episode of Atrial Fibrillation.
Gomes, S., Champ‐Rigot, L., Foucault, A., Arnaud, P., Lebon, A., Scanu, P., & Milliez, P. (2012) · Europe PMC (PubMed Central) · doi:10.4022/jafib.403
Long-Term ECG (Holter) Monitoring and Head-Up Tilt Test
Dora, S. K. (2013) · Springer eBooks · doi:10.1007/978-1-4471-5316-0_12
Waldo, A. L. (2008) · Yearbook of Cardiology · doi:10.1016/s0145-4145(08)06031-0
Diagnostic Procedures for Cardiac Arrhythmias, MI or Hypertension
Alghamdi, O. H., Alamri, H. O., & Eissa, H. A. (2017) · The Egyptian Journal of Hospital Medicine · doi:10.12816/0041688
Krahn, A. D., Yee, R. K., Skanes, A. C., & Klein, G. J. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-2856-5.00064-9
A Point-of-Care Algorithm to Guide Proper Device Selection for Ambulatory Electrocardiography
Farasat, M., Sánchez, J. M., West, J. J., Burke, J. M., Prouse, A., Gore, M. O., Salame, G., Keach, J. W., Trent, S. A., Haigney, M. C., et al. (2021) · Critical Pathways in Cardiology A Journal of Evidence-Based Medicine · doi:10.1097/hpc.0000000000000259
Common Atrial and Ventricular Arrhythmias
Foreman, B. W. (2018) · Contemporary cardiology · doi:10.1007/978-3-319-97622-8_23
Ambulatory Electrocardiography
Rho, R. W., & Page, R. L. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-0285-9.00071-5
Common Atrial and Ventricular Arrhythmias
Foreman, B. W. (2010) · Humana Press eBooks · doi:10.1007/978-1-60327-963-5_24
Introduction to Atrial Fibrillation
Bollmann, A., & Lombardi, F. (2008) · Synthesis lectures on biomedical engineering · doi:10.1007/978-3-031-01633-2_1
Symptom relief for patients with palpitations
Hou, C., Li, D., Wang, Y., & Gan, D. (2023) · Asian Journal of Surgery · doi:10.1016/j.asjsur.2022.12.136
Benditt, D. G., Lü, F., & Sakaguchi, S. (2009) · Wiley eBooks · doi:10.1002/9781444309768.ch42
Benabbas, R., Zehtabchi, S., Wakai, A., Allen, R. W., deSouza, I. S., Richards, R. J., Curley, D., Dunne, E., & Sinert, R. H. (2025) · Academic Emergency Medicine · doi:10.1111/acem.70175
Prolonged Ambulatory ECG Diagnostic Monitoring … Current and Evolving Indications
Brignole, M., & Benditt, D. G. (2010) · Springer eBooks · doi:10.1007/978-0-85729-201-8_8
Electrocardiographic Monitoring and Wearables
Azab, M., & Cheung, C. C. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00058-3
- Authors
- OLSON, J. A., FOUTS, A. M., PADANILAM, B. J., & PRYSTOWSKY, E. N.
- Affiliations
- St Vincent Hospital (US)
- Corresponding author
- PRYSTOWSKY, ERIC N.
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 2007-03-06
- Volume
- 18
- Issue
- 5
- Pages
- 473-477
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W2044837961
- Cited by
- 59
- References
- 10
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 3 · 2018: 4 · 2017: 6 · 2016: 1 · 2014: 3 · 2013: 4 · 2012: 4
- FWCI
- 5.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- palpitations, syncope, presyncope, dizziness, Holter monitoring, arrhythmia diagnosis
- MeSH terms
- Aged, Ambulatory Care, Arrhythmias, Cardiac, Diagnosis, Computer-Assisted, Female, Humans, Male, Middle Aged, Prognosis, Sensitivity and Specificity, Syncope, Telemetry, Reproducibility of Results, Treatment Outcome, Telemedicine
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