[Electrocardiography with R test is effective for diagnosis of arrhythmia in patients who fall].
BACKGROUND
The purpose of the present study was to evaluate the use of R tests (event recorders) in geriatric patients examined at the Falls Clinic from March 2007 to September 2008, and to establish whether the use of R tests is relevant, is of clinical importance, results in overtreatment etc.


METHODS
A total of 207 patients (62 men, and 145 women) were included. Their mean age was 82.8 years. All underwent R-test examination for 5-7 days. The R-test is programmed to store a certain number of arrhythmias and it also records a few seconds before and after the arrhythmia occurs. Furthermore, a pulse trend curve covering the entire period is recorded. A total of 20 minutes of arrhythmias may be stored, and battery capacity is at least eight days. The R-test is easily removed and put back in place as needed.


RESULTS
A total of 136 patients had a normal heart rhythm that did not explain their falls or lightheadedness. 34% needed adjustment of antiarrhythmics. 16.4% needed to see a cardiologist, 8.8% of these due to atrioventricular or sinoatrial block, 14.2% due to tachy-brady syndrome, 11.8% due to ventricular arrhythmias. Five patients were referred to a cardiology department for telemetry, four of these were provided with a pacemaker, another two patients were offered a pacemaker but rejected, six patients died.


CONCLUSIONS
R-test examination for a period of 5-7 days is of great importance to the examination of geriatric fall patients, as 34% of patients needed adjustment of antiarrhythmics, and 16.7% needed to see a cardiologist. The R-test is easy to use and is well-tolerated by patients. The registration period needs to have a duration of at least 5-7 days when the purpose is to reveal seldom occurring, but invalidating arrhythmias in the elderly.
Hvidovre Hospital, Geriatrisk Afdeling, Denmark. info@mettemidttun.dk
Mette
M
Midttun
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male
D000889:Anti-Arrhythmia Agents