Gula Lorne J, Klein George J, Zurawska Urszula, Massel David, Yee Raymond, Skanes Allan C, Krahn Andrew D
Division of Cardiology, University of Western Ontario, London, Ontario, Canada.
Pacing Clin Electrophysiol. 2009 Apr;32(4):466-72. doi: 10.1111/j.1540-8159.2009.02306.x.
The diagnosis of presyncope, syncope, and palpitations is facilitated by successful documentation of the cardiac rhythm during symptoms. We prospectively assessed technological familiarity using a Technology Cognition Questionnaire to determine influence on proper and effective use of an external loop recorder (ELR).
Patients with palpitations, presyncope, or syncope were assessed for familiarity with technology and provided an ELR for a period of 6 weeks. Proper use of the device was demonstrated to the patient and test transmissions were sent by analog telephone line on a weekly basis. Patients were instructed to activate the device to record cardiac rhythm when symptoms recurred, and to send these recordings via telephone transmission.
Ninety-two patients were prospectively enrolled, with mean age 54.9 +/- 20.9 and 42 males (46%). Sixty-five patients (71%) had recurrence of symptoms during the 6-week monitoring period. Among these patients, 40 (62%) were successful in recording and transmitting data such that a diagnosis was made at a median of 8 days (IQR 12.5, range 0-30). Among patients with symptoms during the monitoring period, 36 (55%) had at least one failed recording or transmission. On multivariate analysis, failed symptom recording/transmission was less likely among patients able to program a home video recorder (odds ratio [OR] 0.25 [0.07-0.93]), and more likely among patients who failed a test transmission (OR 3.45 [1.04-11.7]). No variables were independently associated with successful diagnosis.
Familiarity with technology correlates with successful use of the ELR, but does not necessarily correlate with the ability to reach a diagnosis.
症状发作时成功记录心律有助于诊断先兆晕厥、晕厥和心悸。我们使用技术认知问卷对技术熟悉程度进行前瞻性评估，以确定其对外部循环记录仪（ELR）正确有效使用的影响。
对有心悸、先兆晕厥或晕厥的患者进行技术熟悉程度评估，并为其提供ELR，为期6周。向患者演示了该设备的正确使用方法，并每周通过模拟电话线发送测试传输数据。患者被指示在症状复发时激活设备记录心律，并通过电话传输这些记录。
前瞻性纳入92例患者，平均年龄54.9±20.9岁，男性42例（46%）。65例患者（71%）在6周监测期内症状复发。在这些患者中，40例（62%）成功记录并传输了数据，从而在中位数8天（四分位间距12.5，范围0 - 30）时做出了诊断。在监测期内有症状的患者中，36例（55%）至少有一次记录或传输失败。多因素分析显示，能够对家用录像机进行编程的患者症状记录/传输失败的可能性较小（比值比[OR]0.25[0.07 - 0.93]），而测试传输失败的患者可能性较大（OR 3.45[1.04 - 11.7]）。没有变量与成功诊断独立相关。
对技术的熟悉程度与ELR的成功使用相关，但不一定与做出诊断的能力相关。
