24-hour Holter monitoring increased the detection of pertinent arrhythmias to 22.7% compared to 13.8% with 12-hour recordings in patients with periodic cerebral symptoms.
Observational (n=358)
Does Holter monitoring improve the detection of arrhythmias in patients with periodic cerebral symptoms and normal resting ECG?
Holter monitoring, especially for 24 hours, is valuable for detecting underlying arrhythmias in patients with unexplained cerebral symptoms and normal resting ECGs.
Absolute Event Rate: 22.7% vs 13.8%
Holter monitoring was used in 358 patients with symptoms of intermittent dizziness, blackout, or both. The neurological findings in all patients were normal. None manifested evidence of a pertinent arrhythmia on the one-minute resting ECG; 8.9% of the patients demonstrated arrhythmias known to correlate with cerebral symptoms; and 11.2% demonstrated "predisposing" arrhythmias, ie. rhythms that in and of themselves may not precipitate symptoms but predispose to arrhythmias that do. The latter category included short bursts of ectopic tachycardia and intermittent short-duration asystole. High-frequency ectopic beats were observed in 24.6%. In almost every patient in whom intermittent arrhythmias precipitated symptoms there were many "predisposing" arrhythmias of short duration that occurred during the asymptomatic period. A comparison of 12- and 24-hour recordings demonstrated an increase in pertinent arrhythmias from 13.8 to 22.7%.
Jonas et al. (Sun,) conducted a observational in Periodic cerebral symptoms (intermittent dizziness, blackout, or both) (n=358). 24-hour Holter monitoring vs. 12-hour Holter monitoring was evaluated on Detection of pertinent arrhythmias. 24-hour Holter monitoring increased the detection of pertinent arrhythmias to 22.7% compared to 13.8% with 12-hour recordings in patients with periodic cerebral symptoms.