[Utility of cardiac event recorders in diagnosing arrhythmic etiology of palpitations in patients without structural heart disease].
OBJECTIVE
To determine the diagnostic yield of transtelephonic event monitors for identifying the reason for palpitations in patients with no structural heart disease.


METHODS
For 20 months we enrolled all patients reporting palpitations in whom heart disease had been ruled out by medical history, physical examination, ECG and transthoracic echocardiography. All patients underwent 24 h Holter monitoring, which did not provide diagnostic information. Later, a Cardiotest 4DM transtelephonic event monitor was provided to each patient for a mean of 15 3 days. We used SPSS V 10 for statistical analysis.


RESULTS
Two hundred twenty-seven consecutive patients were enrolled. Mean age was 45 3 years (range 12-85); 167 were females (74%). Two hundred twelve of the 227 patients (93.3%) experienced palpitations while wearing the device, and 210 (92.5%) used the monitor correctly, recording the cardiac rhythm during palpitations. Fifteen patients (6.6%) had no palpitations during the days of study. In 125 (55%) the Cardiotest 4DM correctly recorded and transmitted arrhythmia that justified the patients' reference to palpitations. In 35 (15.4%) significant arrhythmia was detected: paroxysmal supraventricular tachycardia in 21, atrial fibrillation in 9, atrial flutter in 5, runs of ventricular extrasystoles in 4 and right outflow tract ventricular tachycardia in 1. Sinus rhythm was recorded during palpitations in 85 patients (37%), and arrhythmia as the cause could be ruled out.


CONCLUSIONS
Cardiotest 4DM identifies arrhythmia in a very high proportion of patients with palpitations and no structural heart disease.
Arjona Barrionuevo
Juan de Dios
Jde D
Servicio de Cardiología. Hospital Universitario Virgen del Rocío. Sevilla. Spain.
Barón-Esquivias
Gonzalo
G
Núñez Rodríguez
Antonio
A
Pérez Carrasco
Alfonso
A
Santana Cabezas
Juan Jesús
JJ
Martínez Martínez
Angel
A
Cayuela
Aurelio
A
Cruz Fernández
José María
JM
Burgos Cornejo
José
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged