Brenner Roman, Altmann David, Ammann Peter
Klinik für Kardiologie, Kantonsspital, St. Gallen.
Ther Umsch. 2014 Feb;71(2):73-9. doi: 10.1024/0040-5930/a000484.
Ambulatory ECG recordings and the memory function of cardiac devices are very useful to record arrhythmias. For this purpose various modalities of documentation are available including externally worn ECGs with variable recording duration and implantable cardiac devices with recording periods over years. The probably most frequent indication for an ambulatory ECG recording is syncope. In contrast to episodic palpitations, syncope is associated with hemodynamic impairment and reduced cerebral perfusion which precludes visiting a physician in order to record an ECG during the attack. Furthermore, ambulatory ECG might be useful in patients with short-lasting palpitations. A selective application of this diagnostic tool might also be appropriate in asymptomatic patients, particularly in order to search for episodes of atrial fibrillation. This indication is of great interest since the introduction of pulmonary vein isolation as a valuable therapeutic option in atrial fibrillation patients to document asymptomatic recurrences for quality control reasons.
动态心电图记录和心脏设备的存储功能对于记录心律失常非常有用。为此，有多种记录方式可供选择，包括记录时长可变的体外佩戴式心电图和记录期长达数年的植入式心脏设备。动态心电图记录最常见的适应证可能是晕厥。与发作性心悸不同，晕厥与血流动力学损害和脑灌注减少有关，这使得患者无法在发作时就医进行心电图记录。此外，动态心电图对短暂心悸患者可能也有用。对于无症状患者，选择性应用这种诊断工具可能也是合适的，特别是为了查找房颤发作。自从将肺静脉隔离作为房颤患者一种有价值的治疗选择引入以来，出于质量控制原因记录无症状复发，这一适应证就备受关注。
