title: Comparison of the patient-activated event recording system vs. traditional 24 h Holter electrocardiography in individuals with paroxysmal palpitations or dizziness.
abstract: OBJECTIVE
  Electrocardiographic documentation of symptomatic episodes of palpitations by means of traditional methods such as 24 h Holter monitoring (HM) or loop recorders is challenging. Patient-activated electrocardiography (ECG) recorders have been proved to be a useful tool in the diagnosis of arrhythmias in these patients. However, no comparison studies between the two techniques have been conducted. The aim of this study was to compare the diagnostic value of Holter ECG and a patient-activated event recorder (OMRON portable HeartScan ECG Monitor(®)) (HeartScan) in the detection of arrhythmias in patients with paroxysmal palpitations or dizziness suggestive of cardiac arrhythmias.
  
  
  RESULTS
  Patients with paroxysmal palpitations or dizziness were eligible for this study. All patients underwent an HM for 24 h and a 15-day HeartScan after the HM. Six hundred and twenty-five patients (48% male, mean age: 37 ± 11 years) were included in the study. All patients present with normal heart structure, normal baseline 12-lead ECG, and normal echocardiogram. Indications for ECG monitoring were palpitations in 577 patients (92.3%) and dizziness in 48 (7.7%). Holter monitoring offered a clinical diagnosis in 11 patients (1.8%). Conversely, HeartScan diagnosed the clinical arrhythmia in 558 individuals (89%). Detection of symptoms-related arrhythmias by means of HeartScan was significantly higher when compared with HM (P < 0.01).
  
  
  CONCLUSIONS
  The studied system proved to be an efficient event recorder providing the diagnosis of the clinical arrhythmia in 89% of patients with paroxysmal palpitations or dizziness. Further studies are needed to confirm our results.
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium carlodeasmundis@me.com carlo.deasmundis@uzbrussel.be.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Moises
authors.initials: M
authors.lastname: Rodriguez-Manero
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Moises
authors.initials: M
authors.lastname: Levinstein
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Rubén
authors.initials: R
authors.lastname: Casado-Arroyo
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D004244:Dizziness / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography / Q000295:instrumentation* / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D004867:Equipment Design; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors
keywords: 24 h Holter-ECG recording; HeartScan; Palpitations; Patient-activated event recorder