Tidsskr Nor Laegeforen. 2020 Feb 10;140(3). doi: 10.4045/tidsskr.19.0434. Print 2020 Feb 25.
Long-term ECG recording is a commonly used test. However, there are no clear guidelines on who should be examined using this method, and we lack an overview of the results of testing and their therapeutic implications.
All long-term ECG recordings performed at Sørlandet Hospital Arendal in the period 2017-18 were included in the study. The tests were identified by searching the medical records system for relevant procedure codes, and all medical records related to the test were subsequently reviewed. Patient characteristics, referrer, indication, results, further assessment, and treatment were recorded.
A total of 1 262 long-term ECG recordings were performed at Sørlandet Hospital Arendal in the period 2017-18. The median age of those tested was 60 years, and 48 % of tests were performed in women. A total of 253 (20 %) recordings revealed arrhythmias and 168 (13 %) had therapeutic implications. For patients without known heart disease or a history of stroke (n = 619 (49 %)), the test had therapeutic implications in 32 (5 %) cases.
Long-term ECG recording was often used to test patient populations with limited cardiac arrhythmia, and the results rarely had therapeutic implications. The findings of the study may indicate that long-term ECG recording should be used to a greater extent in patients for whom positive findings would have therapeutic and prognostic implications, such as those in whom stroke prophylaxis would be indicated if they were found to have atrial fibrillation.
长期心电图记录是一种常用的检查方法。然而,目前尚无明确的指南规定哪些患者应使用这种方法进行检查,我们也缺乏对检查结果及其治疗意义的全面了解。
本研究纳入了 2017-18 年期间在索兰德医院阿伦达尔进行的所有长期心电图记录。通过在病历系统中搜索相关程序代码来识别这些检查,随后对所有与检查相关的病历进行了审查。记录了患者的特征、转诊医生、检查指征、检查结果、进一步评估和治疗情况。
2017-18 年期间,在索兰德医院阿伦达尔共进行了 1262 次长期心电图记录。接受检查者的中位年龄为 60 岁,48%的检查是在女性中进行的。共有 253 次(20%)记录显示心律失常,168 次(13%)有治疗意义。对于无已知心脏病或中风史的患者(n=619(49%)),有 32 例(5%)的检查结果具有治疗意义。
长期心电图记录常用于检查心律失常风险有限的患者人群,且结果很少具有治疗意义。本研究的结果表明,对于那些如果发现有心房颤动则需要进行卒中预防治疗的患者,如发现心律失常可能具有治疗和预后意义的患者,长期心电图记录的应用范围应进一步扩大。