The duration of Holter monitoring in patients with syncope. Is 24 hours enough?

摘要: To determine the incremental yield of ambulatory monitoring in evaluation syncope, three serial 24-hour Holter recordings were obtained a consecutive series 95 patients with cause which was not explained by history, physical examination, or 12-lead electrocardiogram. The mean age 61 years and 41% men. Major electrocardiographic abnormalities found 26 (27%), including unsustained ventricular tachycardia (19 patients), pauses at least 2 seconds (8 profound bradycardia (1 patient), complete heart block patient). first recording had one major abnormality 14 (15%) (95% confidence interval, 8.3% to 23.4%). Of 81 without on recording, second 9 (11%) 5.1% 20.0%). 72 two recordings, only 3 (4.2%) third 0.8% 11.7%). Four factors significantly associated an increased likelihood hours monitoring: above 65 (relative risk, 2.2), male gender 2.0), history disease initial nonsinus rhythm 3.5). These results suggest that 24 is enough identify all potentially important arrhythmias syncope. Monitoring may need be extended 48 if normal.