Scalvini S, Zanelli E, Martinelli G, Baratti D, Giordano A, Glisenti F
Cardiology Division, S Maugeri Foundation, IRCCS, Gussago, Brescia, Italy.
J Telemed Telecare. 2005;11 Suppl 1:14-6. doi: 10.1258/1357633054461930.
Palpitation is a common symptom that sometimes results from a substantial cardiac arrhythmia. We compared the diagnostic yield of trans-telephonic event monitors with those of Holter monitoring in patients with intermittent palpitations. In all, 310 patients were randomly assigned to receive an event recorder or 24-hour Holter monitoring. Event recorders were used for seven days or until two recordings were obtained while symptoms occurred. The main end-point was an electrocardiogram (ECG) recorded during symptoms. The patients with palpitation recorded the one-lead ECG trace and sent it to a telemedicine call centre, where a nurse responded. There were 119 symptomatic patients in the event recorder group and 74 in the Holter group. The total costs were 6019 for event recording and 9605 for Holter monitoring. The average costs were 51 per symptomatic patient detected by event recorder monitoring and 130 per symptomatic patient detected by Holter monitoring. More patients therefore received a clear diagnosis, and more quickly, when using event recording than with Holter monitoring. For this reason, event recorders are preferable to Holter monitors for patients with palpitations.
心悸是一种常见症状，有时由严重心律失常引起。我们比较了经电话事件监测仪与动态心电图监测仪对间歇性心悸患者的诊断效果。总共310例患者被随机分配接受事件记录仪或24小时动态心电图监测。事件记录仪使用7天或直至在症状发作时获得两份记录。主要终点是症状发作时记录的心电图（ECG）。心悸患者记录单导联心电图轨迹并发送至远程医疗呼叫中心，由护士进行回应。事件记录仪组有119例有症状患者，动态心电图组有74例。事件记录的总费用为6019，动态心电图监测的费用为9605。通过事件记录仪监测发现的有症状患者平均费用为51，通过动态心电图监测发现的有症状患者平均费用为130。因此，与动态心电图监测相比，使用事件记录时更多患者得到了明确诊断，且诊断更快。出于这个原因，对于心悸患者，事件记录仪比动态心电图监测仪更可取。
