Significance of external loop recorders (ELR) in diagnosis of disturbances in heart rhythm

Abstract

Background. Heart palpitations are frequently reported by patients but have non-specific character, which poses a principal diagnostic difficulty. There are several methods of ECG monitoring, however selection and duration of such recording should be guided by the expected time of repeated symptoms. External loop recorder (ELR) represents an external recording instrument in patients who have an inter-symptom interval ≤ 4 weeks. Objectives. This study aimed at evaluation of ELR usefulness in patients with periodic manifestation of heart palpitations and at evaluation of prevalence of arrhythmias in this group of patients. Material and methods. The study was conducted on 48 patients, including 38 women and 10 men. Mean age of the patients was 48.5 ± 18 years. Duration of the monitoring period using ELR recorder varied from 3 to 10 days, depending on manifestation of subjective symptoms. Results. Abnormalities in ECG record were detected in 33 patients (68.75%). In the remaining 15 patients (31.25%) ECG records were normal. Most frequently (in 77.08% patients) benign alterations were disclosed, including sinus tachycardia, premature supraventricular complexes and premature ventricular complexes, a group of disturbances defined as clinically significant was manifested in 27.08% of examined patients. Alterations of ischemic character accounted for 20.83% of disturbances. Conclusions. External loop recorder is an easy tool for diagnosing heart palpitations in case when Holter monitoring is not conclusive. The group of people in whom external loop recorders should be specially applicable are elderly individuals, due to the physiological changes in conduction system in the course of the aging process.