title: Ambulatory external electrocardiographic monitoring: focus on atrial fibrillation.
abstract: There has been progressive development in ambulatory external electrocardiogram (AECG) monitoring technology. AECG monitors initially consisted of 24- to 48-h Holter monitors and patient-activated event and loop recorders. More recently, several ambulatory cardiovascular telemetry monitors and a patch-type 7- to 14-day Holter monitor have been introduced. These monitoring systems are reviewed along with their utility and limitations, with particular emphasis on their role in the diagnosis and evaluation of patients with atrial fibrillation (AF). AECG monitoring is necessary when asymptomatic AF is suspected (as in patients presenting with cryptogenic stroke) or when an ECG diagnosis of unexplained arrhythmic symptoms is warranted. In addition, AECG plays an important role in patients with known AF to guide ventricular rate control and anticoagulation therapy, and assess the efficacy of antiarrhythmic drug therapy and/or ablation procedures. Finally, we outline areas of uncertainty and provide recommendations for use of available AECG monitors in clinical practice.
authors: Valley Heart and Vascular Institute, Columbia University College of Physicians & Surgeons, New York, New York, USA. smittal@chpnet.org
authors: Suneet
authors: S
authors: Mittal
authors: Colin
authors: C
authors: Movsowitz
authors: Jonathan S
authors: JS
authors: Steinberg
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation*; D006801:Humans; D017063:Outcome Assessment, Health Care; D013686:Telemetry; D035501:Uncertainty