Observations on ambulatory electrocardiographic monitoring in clinical practice.
Holter monitoring is a practical technique for determining rate, rhythm, contour, and conduction changes in the electrocardiogram of the ambulatory patient. This kind of information may be of great clinical importance in coronary artery disease with or without myocardial infarction, in patients with permanent pacemakers, in the presence of central nervous system symptoms, and perhaps in patients with chronic obstructive pulmonary disease. Correlating ambulatory electrocardiographic findings in patients with these diseases and syndromes provides insight into the severity of the process involved. It may also define the response to therapy and to specific social and work situations. Present instrumentation, although reasonably effective, may be considered in an early developmental stage. Future progress in terms of miniaturization, automatic patient warning systems, and activation of central recording units, may further broaden the implications for ambulatory electrocardiographic monitoring. The scope of these observations and the variety of unsuspected rhythm and contour abnormalities defined may ultimately rival the information gained in monitored hospitalized patients. It is hoped that this information will have an impact on the therapy of the ambulatory patient comparable to that which coronary-care unit monitoring has had on the hospitalized patient with acute myocardial infarction.
D000328:Adult; D000359:Aftercare; D000368:Aged; D000553:Ambulatory Care; D000787:Angina Pectoris / Q000175:diagnosis; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D002493:Central Nervous System Diseases / Q000175:diagnosis; D002648:Child; D003327:Coronary Disease / Q000175:diagnosis; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000628:therapy; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis