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Early Detection of Symptomatic Paroxysmal Cardiac Arrhythmias by Trans‐Telephonic ECG Monitoring: Impact on Diagnosis and Treatment of Atrial Fibrillation
Author(s) -
ANCZYKOWSKI JOHANNA,
WILLEMS STEPHAN,
HOFFMANN BORIS A.,
MEINERTZ THOMAS,
BLANKENBERG STEFAN,
PATTEN MONICA
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13025
Subject(s) - medicine , cardiology , atrial fibrillation , sinus tachycardia , sinus rhythm , sinus bradycardia , implantable loop recorder , cardioversion , holter monitor , atrial tachycardia , electrocardiography , ablation , catheter ablation , bradycardia , anesthesia , heart rate , blood pressure
Trans‐Telephonic ECG Monitoring for the Detection of CA Introduction Diagnosis of infrequent cardiac arrhythmias (CA) is often unsuccessful using resting or Holter ECG. As early detection and treatment of CA, especially atrial fibrillation (AF), has implications on patients’ treatment and outcome, we investigated, whether self‐guided, trans‐telephonic event‐recorder monitoring (Tele‐ECG) improves diagnosis and influences treatment options. Methods Between 2009 and 2014, 790 patients (54 ± 18 years, 40% male; no history of CA: 582, known AF: 179, other CA: 29) presented with recurrent symptoms suggestive of CA and were screened by Tele‐ECG (17.3 ± 26.9 days). A total of 11,775 ECGs were transmitted via a 24‐hour telephone hotline including documentation of the respective symptoms. Results In 73% of patients, CA was documented at the time of symptoms: sinus tachycardia 23%, premature ventricular beats 19%, AF 14%, supraventricular tachycardia 9%, sinus bradycardia 5%, sinus arrhythmia 2%, and AV block II 1%. The mean time until the first symptomatic episode occurred was 6.9 ± 15.3 days (median 2.5 days). The first documented arrhythmia occurred on average after 7.7 ± 14.1 days (median 3 days). In patients with AF (n = 110), 44% was newly diagnosed. According to the Tele‐ECG diagnosis, AF ablation was performed in 27% of these patients, 7% electrical cardioversion, and in 30% antiarrhythmic therapy was initiated. In 65% of the patients with recurrence of known AF, (re‐)ablation was performed or recommended and in 16% antiarrhythmic therapy was modified. Conclusions Tele‐ECG monitoring is effective in the diagnosis of suspected symptomatic CA. A diagnosis can usually be achieved within 1 week and has implications on patients’ care.