[Advantage of ECG self-recording by the patient].

The study reported here concerns new, computerized ECG devices (R-Test 160, Heartner) which the patient can carry in his pocket and use to register cardiac episodes. Seventy-two patients experiencing sudden episodes--not of daily occurrence--marked by palpitations or irregular pulse were supplied with a device on a total of 83 occasions. The total number of attacks registered was 93. The Heartner device was used by pressing it lightly over the precordial region. The R-Test instrument, on the other hand, required attachment of two conducting arm-bands. Forty-four (61%) of the patients had no organic heart disease. During a mean observation time of 17 +/- 9 days, 28 of the patients (39%) recorded symptomatic episodes, of which 11 consisted of normocardiac sinus rhythm, 7 of sinus tachycardia and only 10 (14%) of arrhythmia. The commonest reasons for a negative test result were freedom from episodes during the observation period (22 patients) and episodes of too short a duration (6 patients). In practice, arrhythmias are not easy to detect with these "home micro-Holters". Those registered correlate poorly with the subjective symptoms, an observation already reported in a number of other Holter studies. Moreover, immediate recording of any arrhythmia occurring is not possible with the devices used in our study. The average delay in starting a recording, caused by the need to attach and switch on the device, is one minute. These ECG devices are of practical use mainly for verifying functional cardiac disorders or as an alternative method in cooperative patients with arrhythmia episodes occurring infrequently and lasting at least one minute.