Sorgato A, Rusconi C, Marchetti A, Simoncelli U
Divisione di Cardiologia, Ospedale S. Orsola, Brescia.
Minerva Cardioangiol. 1992 Nov;40(11):437-47.
The value of ambulatory ECG monitoring in the investigation of arrhythmic or ischemic events with paroxysmal patterns is well-known and its use is widespread. More recently, technical advances in informatics and in ECG signal digitizing have rapidly developed the current available ambulatory ECG instruments, reducing the time necessary for pattern analysis meanwhile assuring acceptable accuracy and reliability of the results. ECG recording techniques other than traditional Holter monitoring are now available such as transtelephonic transmission of ECG signal recorded in real time or previously stored in solid state memory by intermittent recorders that can be switched on by the patients himself at the first prodroms or at the end of the event. These "loop recorders" make it possible to indefinitely extend ECG monitoring time, reducing costs and increasing record sensitivity in comparison to conventional Holter monitoring. Moreover, recent technological development of Holter monitoring makes it possible to perform heart rate variability analysis and late potentials research in addition to traditional analysis of cardiac rate and ventricular repolarization. Thus Holter recording may become, combined with other usual risk factors, a polyparametrical non invasive approach to sudden cardiac death risk assessment characterised by low cost/benefit ratio and by large screening capacity.
动态心电图监测在阵发性心律失常或缺血性事件调查中的价值是众所周知的，并且其应用广泛。最近，信息学和心电图信号数字化方面的技术进步迅速推动了当前可用的动态心电图仪器的发展，减少了模式分析所需的时间，同时确保了结果具有可接受的准确性和可靠性。现在有了除传统动态心电图监测之外的心电图记录技术，例如实时记录的心电图信号的经电话传输，或者由患者本人在首次前驱症状出现时或事件结束时开启的间歇记录仪预先存储在固态存储器中的心电图信号的经电话传输。这些“环路记录器”使得无限期延长心电图监测时间成为可能，与传统动态心电图监测相比，降低了成本并提高了记录敏感性。此外，动态心电图监测的最新技术发展使得除了对心率和心室复极进行传统分析之外，还能够进行心率变异性分析和晚电位研究。因此，动态心电图记录结合其他常见危险因素，可能成为一种多参数无创性方法，用于评估心脏性猝死风险，其特点是成本效益比低且筛查能力强。
