Subbiah Rajesh, Gula Lorne J, Klein George J, Skanes Allan C, Yee Raymond, Krahn Andrew D
Division of Cardiology, University of Western Ontario, London, Ontario, Canada.
Curr Cardiol Rev. 2008 Feb;4(1):41-8. doi: 10.2174/157340308783565447.
Elucidating the underlying cause of unexplained syncope, palpitations or other possible arrhythmia-related symptoms is a formidable clinical challenge. Cardiac monitoring supplements the most important "test" in patients with syncope or palpitations, that of a thoughtful history and physical examination. Ideally, comprehensive physiologic monitoring during spontaneous symptoms would constitute what, at present, is an unattainable gold standard test for establishing a cause. Short of that goal, establishing an accurate symptom-rhythm correlation can often provide a diagnosis. Ambulatory outpatient monitoring is a powerful diagnostic tool for the evaluation of cardiac arrhythmias. Evolving technologies have provided a vast array of monitoring options for patients suspected of having cardiac arrhythmias, with each modality differing in duration of monitoring, quality of recording, convenience and invasiveness. Holter monitors, event monitors and external loop recorders are non-invasive and provide easily accessible short-term monitoring solutions. In instances where the diagnosis remains elusive, a more long-term strategy with an implantable loop recorder may be the preferred path.
阐明不明原因晕厥、心悸或其他可能与心律失常相关症状的潜在病因是一项艰巨的临床挑战。心脏监测是晕厥或心悸患者最重要的“检查”（即详尽的病史采集和体格检查）的补充。理想情况下，在自发症状期间进行全面的生理监测将构成目前用于确定病因的难以实现的金标准检查。在无法实现该目标的情况下，建立准确的症状与节律相关性通常可提供诊断。门诊动态监测是评估心律失常的强大诊断工具。不断发展的技术为疑似有心律失常的患者提供了大量监测选项，每种方式在监测时长、记录质量、便利性和侵入性方面各不相同。动态心电图监测仪、事件监测仪和体外循环记录仪是非侵入性的，提供了易于获取的短期监测解决方案。在诊断仍不明确的情况下，采用植入式循环记录仪的更长期策略可能是首选途径。
