What does the symptom "palpitation" mean? - Correlation between symptoms and the presence of cardiac arrhythmias in the ambulatory Ecg.

The correlation between palpitations and arrhythmias was examined using 319 long term Ecgs of 167 patients. Furthermore, we attempted to determine the shortest possible recording time permitting the correct diagnosis of an arrhythmia and ST-segment changes. 31 arrhythmias (9.7%) were correctly identified by our patients; On the other hand, while there were 20 palpitations (39%) that could not be related to an arrhythmia we recorded 39 instances in which these same patients missed an arrhythmia. Tachycardias and multiple ventricular extrasystoles were most likely identified. Most of the rhythm disturbances (89%) appeared during the first 12 hours and all of the ST-segment changes eventually seen (100%) occurred until the end of 8 hours of recording. This study shows that ths symptom "palpitation" is a poor indicator of underlying rhythm disturbances. In the documentation of arrhythmias and/or ischemic ST-segment changes 8 to 12 hours of recording should usually be sufficient.