Linzer M, Pritchett E L, Pontinen M, McCarthy E, Divine G W
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Am J Cardiol. 1990 Jul 15;66(2):214-9. doi: 10.1016/0002-9149(90)90591-n.
The Holter monitor, the most frequently used diagnostic test in patients with syncope, is nondiagnostic in over 90% of cases. This study sought to determine the impact of a new noninvasive device, the cardiac loop electrocardiographic (ECG) recorder, after Holter monitoring in 57 patients with unexplained syncope. All patients underwent a standardized evaluation protocol and were the monitor for up to 1 month. In 14 patients, loop recording definitively determined whether an arrhythmia was the cause of symptoms (diagnostic yield 25%; 95% confidence intervals 14 to 38%). Diagnoses included unsuspected ventricular tachycardia (1 patient), high grade atrioventricular block (2 patients), supraventricular tachycardia (1 patient), asystole or junctional bradycardia from neurally mediated syncope (3 patients) and normal cardiac rhythms (the remaining 7 patients). Follow-up of all patients diagnosed as having nonarrhythmic syncope by loop recording showed that none of these patients died suddenly. Cardiac loop ECG recording is an important new diagnostic test in patients with syncope unexplained by Holter monitoring.
动态心电图监测仪是晕厥患者最常用的诊断检查方法，但在超过90%的病例中无法得出诊断结果。本研究旨在确定一种新型无创设备——心脏环式心电图（ECG）记录仪，在对57例不明原因晕厥患者进行动态心电图监测后的诊断效果。所有患者均接受了标准化评估方案，并使用该记录仪监测长达1个月。在14例患者中，环式记录明确确定了心律失常是否为症状的病因（诊断率为25%；95%置信区间为14%至38%）。诊断结果包括未被怀疑的室性心动过速（1例患者）、高度房室传导阻滞（2例患者）、室上性心动过速（1例患者）、神经介导性晕厥导致的心脏停搏或交界性心动过缓（3例患者）以及正常心律（其余7例患者）。对所有经环式记录诊断为非心律失常性晕厥的患者进行随访发现，这些患者均未发生猝死。心脏环式ECG记录是一种重要的新型诊断检查方法，可用于动态心电图监测无法明确病因的晕厥患者。
