Current status of ambulatory electrocardiography

Abstract

Ambulatory electrocardiographic (ECG) recordings have become an important clinical tool for the diagnosis and management of patients with symptoms suggesting cardiac arrhythmias or with known cardiac rhythm disturbances. One or more forms of long-term ambulatory ECG monitoring. are currently available to almost all practicing physicians. Because of the expense of the equipment and considerable technician and physician time required for data reduction and interpretation, these tests are relatively expensive, generally ranging from $150 to $250. However, when used appropriately they can be a cost-effective tool and may prevent hospitalizations for continuous ECG recording. In order to optimize the benefit of these recordings the clinician must be familiar with the types of recordings available and the specific clinical situations in which they are likely to yield important information. Their largest proven clinical use is for the evaluation of symptomatic patients to document suspected rhythm disturbances. Currently they play a more limited role in the long-term management of patients with arrhythmias, in large part, due to our lack of knowledge regarding the benefits of prophylactic therapy given to treat asymptomatic arrhythmias detected on these recordings. This presentation examines the types of long-term ambulatory ECG recordings available, describes the clinical situations in which each is most useful, and discusses the use of these recordings in both symptomatic and asymptomatic patients with known or suspected cardiac arrhythmias.