Die Bedeutung des Langzeit-EKG für die Schrittmacherambulanz

Abstract

Reports from the literature show that Holter monitoring is more sensitive in detecting pacemaker dysfunction than 12-lead ECG. Holter monitoring is, therefore, an additional useful tool in the pacemaker follow-up clinic. Data from the literature show that pacemaker dysfunctions are more frequent than patients‘ history and common standard techniques of the pacemaker follow-up clinic may suggest. All patients, therefore, should undergo Holter monitoring during follow-up. The following indications for Holter monitoring in pacemaker patients are commonly accepted: detection of pacemaker dysfunctions or spontaneous arrhythmias in symptomatic patients, surveillance of asymptomatic patients at least after implantation of complex multiprogrammable pacemakers, assessment of spontaneous heart rate in pacemaker patients, and sensor function in rate adaptive pacemakers. In patients with dual-chamber pacemakers Holter monitoring is useful in detecting atrial arrhythmias, especially atrial fibrillation affecting adequate pacemaker function, and pacemaker-mediated tachycardias. Diagnostic sensitivity of Holter monitoring in detecting transient pacemaker dysfunctions can be further improved by computer-aided analysis, which is still limited to the evaluation of ventricular inhibited demand pacemakers. In many cases only visual analysis is possible. The prognostic value of transient pacemaker dysfunctions detected by Holter monitoring should be clarified by long-term follow-up studies.