Initial Experience with Novel Mobile Cardiac Outpatient Telemetry for Children and Adolescents with Suspected Arrhythmia

Abstract

To report use of a novel mobile cardiac outpatient telemetry (MCOT) system for evaluation of children and adolescents with suspected cardiac arrhythmia. Prospective data collection and retrospective analysis. All patients who received MCOT from The Children's Hospital at the Cleveland Clinic between 1/14/04 and 2/12/05 were screened. Patients older than 21 years and those with previously documented arrhythmia were excluded. Fifty-nine consecutive MCOT studies were performed. Five patients met exclusion criteria leaving 54 subjects (mean age 12.4+/-4.5 years; range 3.2-19.7 years; 46% male) for inclusion. The MCOT system (CardioNet, USA) consists of a 3-electrode, 2-channel sensor that transmits wirelessly to a portable monitor. Monitors continuously store, analyze, and transmit the electrocardiogram through cellular and land telephone networks to a central station. MCOT was performed for 9-32 consecutive days (mean 24.5+/-7.4). Results. Twenty-one subjects (39%) did not experience symptoms during MCOT, yielding a diagnostic rate of 61% (N = 33). Of the 33 diagnostic studies, 9% (N = 3; mean age 16.9+/-0.6 years; range 16.2-17.3 years; 1 male) showed supraventricular tachycardia and 9% (N = 3; mean age 11.1+/-2.7 years; range 8.2-13.5 years; 1 male) showed supraventricular or ventricular ectopy. Minor skin irritation at sites of electrode placement was the only complication of MCOT (N = 5). MCOT is safe and useful for evaluation of children and adolescents with suspected arrhythmia, providing a diagnosis in 61% of subjects. The diagnostic yield of MCOT was superior to that expected from traditional event and Holter monitors in this pediatric population.