title: Use of a Patient-Activated Event Recording System in Patients with Tachycardic Palpitations: How Long to Follow Up?
abstract: BACKGROUND
  Palpitations are a common symptom causing patients to consult a cardiologist, yet diagnosing a potential cardiac origin can be difficult. In patients with a nondiagnostic Holter-ECG, external loop-recorders are an additional tool to diagnose the clinical arrhythmia in these patients. The aim of our study was to evaluate the additional value of an external, patient-activated loop recorder and to determine the optimal time of follow up needed to achieve a symptom-rhythm correlation with the device.
  
  
  RESULTS
  A total of 1404 patients presented to our outpatient clinic between November 2011 and November 2014 for first time evaluation of symptomatic arrhythmias. Of a total of 91 patients were included (age 43.6±18.1; 69.2% female) in the study. All patients presented with tachycardic palpitations and a 48-hour Holter-ECG that did not detect relevant arrhythmias. All patients were given a "leadless" patient-activated event-recording system and regular follow-up visits were scheduled after 3, 6, and 12 months. Within a maximum follow-up time of 1 year, 72 patients (79.1%) recorded at least one ECG with the device. Of the recorded ECGs, 51% were recorded within the first week after the device was handed out. This figure rises to 80% and 93% after 1 and 2 months. The last recording was after 174 days.
  
  
  CONCLUSIONS
  For patients with tachycardic palpitations, the external "leadess" event recorders are effective in achieving a symptom-rhythm correlation. A follow up of 2 months will suffice to establish a diagnosis in a large majority of this patient group.
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Philipp
authors.initials: P
authors.lastname: Attanasio
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Martin
authors.initials: M
authors.lastname: Huemer
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Lena
authors.initials: L
authors.lastname: Loehr
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Abdul Shokor
authors.initials: AS
authors.lastname: Parwani
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Leif-Hendrik
authors.initials: LH
authors.lastname: Boldt
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin.
authors.forename: Alexander
authors.initials: A
authors.lastname: Wutzler
mesh_terms: D000328:Adult; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D013610:Tachycardia / Q000175:diagnosis*; D013997:Time Factors
keywords: Holter/event recorders; atrial arrhythmias; electrocardiography