Evaluation of Outpatient Arrhythmias and Pacemakers Utilizing Transtelephonic Monitoring Devices

Background: The purpose of this trial was to evaluate a patient actuated transtelephonic cardiac monitoring system in order to document cardiac arrhythmias and cardiac pacemaker function. Material: Eighty‐two patients were prospectively evaluated, 69 with pacemaker (group I) and 13 with symptomatic arrhythmias (group II). Two different recorders were used: a memory loop‐recorder (KH) and a wrist‐worn recorder (HW). Both of them were implemented using a small, portable, battery‐powered transmitter, which monitors a modified V5 in KH and a lead 1 with the HW over regular nondigital pulse telephone lines. Results: In group I, 54 patients used single chamber pacemakers, 2 VDDR, and 13 used dual chamber devices. In group II, all patients included referred palpitations as their symptom. In group I, 248 registers were made using the KH and 50 with the HW. Recordings were made with KH had a 96% accuracy in the diagnosis of the ECG, while HW recordings failed to detect the QRS and the spike in 52% of the cases. Arrhythmia patients (group II) made 65 recordings with KH, all symptomatic: 28 were ventricular ectopic beats (23 isolated, 4 bigeminy, and 1 coupled ventricular ectopic beats); 9 supraventricular ectopic beats (isolated); 18 episodes of sinus tachycardia; and 10 normal sinus rhythm. Artifact was present partially in 6 other recordings, but did not affect the diagnosis. Two patients made no recordings and were excluded from the trial (group I). Conclusions: The loop‐recording transtelephonic monitoring system is an excellent tool for the evaluation of patients with symptomatic arrhythmias and pacemaker. The memory KH had an excellent performance, even over regular telephone lines. The accuracy of the HW recordings was low and failed to evaluate the QRS, probably due to the direction of the AQRS vector.