ACC/AHA Guidelines for Ambulatory Electrocardiography: Executive Summary and Recommendations

Abstract

I. Introduction Improvements in solid-state digital technology have enhanced transtelephonic transmission of electrocardiography (ECG) data and increased the accuracy of software-based analysis systems. These advances, in addition to better signal quality and greater computer arrhythmia interpretation capabilities, have opened new potential uses for ambulatory electrocardiography (AECG). Traditional uses of AECG for arrhythmia detection have expanded as the result of increased use of multichannel and telemetered signals. The clinical application of arrhythmia monitoring to assess drug and device efficacy has been further defined by new studies. The analysis of transient ST-segment deviation remains controversial, but considerably more data are now available, especially about the prognostic value of detecting asymptomatic ischemia. Heart rate variability (HRV) analysis has shown promise for predicting mortality rates in cardiac patients at high risk. Despite these advances, a true automated analysis system has not been perfected