Cardiac event recording yields more diagnoses than 24–hour Holter monitoring in patients with palpitations

Author:

Scalvini S1,Zanelli E1,Martinelli G1,Baratti D1,Giordano A1,Glisenti F2

Affiliation:

1. Cardiology Division, S Maugeri Foundation, IRCCS, Gussago, Brescia

2. Health Telematic Network S.p.A., Brescia, Italy

Abstract

Palpitation is a common symptom that sometimes results from a substantial cardiac arrhythmia. We compared the diagnostic yield of trans-telephonic event monitors with those of Holter monitoring in patients with intermittent palpitations. In all, 310 patients were randomly assigned to receive an event recorder or 24–hour Holter monitoring. Event recorders were used for seven days or until two recordings were obtained while symptoms occurred. The main end-point was an electrocardiogram (ECG) recorded during symptoms. The patients with palpitation recorded the one-lead ECG trace and sent it to a telemedicine call centre, where a nurse responded. There were 119 symptomatic patients in the event recorder group and 74 in the Holter group. The total costs were €6019 for event recording and €9605 for Holter monitoring. The average costs were €51 per symptomatic patient detected by event recorder monitoring and €1 30 per symptomatic patient detected by Holter monitoring. More patients therefore received a clear diagnosis, and more quickly, when using event recording than with Holter monitoring. For this reason, event recorders are preferable to Holter monitors for patients with palpitations.

Publisher

SAGE Publications

Subject

Health Informatics

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