Minerva cardioangiologica · 1993
[Value of continuous electrocardiographic monitoring of patients with syncope. Results of a prospective study].
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Racco F, Sconocchini C, Reginelli R, Brizzi G, Alesi C, Rosati S, Strobio G C, Pratillo G, Melappioni A
Аннотация
AIM: Syncope, a temporary loss of conscience, is a frequent cause for consulting the family doctor or more often being brought to the hospital emergency ward. In order to evaluate the importance of the continuous recording of ECG in the formulation of the diagnosis, the relevant data were extrapolated from more general data in the prospective study.
MATERIAL: A total of 194 patients were enrolled whose diagnosis was divided into three distinct stages. Continuous echographic registration using Holter's method and/or bedside monitoring was included in the 2nd stage and was performed in 134 patients.
RESULTS: 102 out of 134 patients (76.11%) showed rhythm alterations: varying degrees of atrio-ventricular block were recorded in 6 patients; supraventricular arrhythmia in 73 cases which were divided according to a modified to a modified version of Lawn's classification. Continuous ECG recording alone proved decisive in formulating a diagnosis in 6 patients (one of which together with echocardiogram): in 2 patients due to the presence of complex ventricular extrasystoles; in 4 due to torsion of the tip, sinusal arrest, cardiac arrest, supraventricular tachycardia with aberrant intraventricular conduction, respectively.
CONCLUSIONS: Especially when standard surface ECG is carried out rapidly following an acute attack, continuous ECG recording is of scant diagnostic value due to the etiological definition of syncope. But due to its moderate cost and non-invasive character it is worth performing in syncopes of suspected cardiogenic etiology with a more severe prognosis.
MATERIAL: A total of 194 patients were enrolled whose diagnosis was divided into three distinct stages. Continuous echographic registration using Holter's method and/or bedside monitoring was included in the 2nd stage and was performed in 134 patients.
RESULTS: 102 out of 134 patients (76.11%) showed rhythm alterations: varying degrees of atrio-ventricular block were recorded in 6 patients; supraventricular arrhythmia in 73 cases which were divided according to a modified to a modified version of Lawn's classification. Continuous ECG recording alone proved decisive in formulating a diagnosis in 6 patients (one of which together with echocardiogram): in 2 patients due to the presence of complex ventricular extrasystoles; in 4 due to torsion of the tip, sinusal arrest, cardiac arrest, supraventricular tachycardia with aberrant intraventricular conduction, respectively.
CONCLUSIONS: Especially when standard surface ECG is carried out rapidly following an acute attack, continuous ECG recording is of scant diagnostic value due to the etiological definition of syncope. But due to its moderate cost and non-invasive character it is worth performing in syncopes of suspected cardiogenic etiology with a more severe prognosis.