[Value of computer-assisted, digital long-term ECG analysis in clinical routine practice].

At present the Holter method (HM) is a frequently used investigational procedure in the clinical routine. It was the aim of a prospective study to evaluate the HM from the user's point of view. Therefore a questionnaire was attached to each analysis report including two main questions, which should be answered by the referring physician: Does the analysis result fulfill the consumer's needs? What consequences are drawn due to the HM results? Among 675 questionnaires returned to the laboratory 75% of the referring physicians felt satisfied by the HM result. Disappointments were predominantly related to too infrequently occurring episodes, which did not appear during one 24-hour recording period. Evaluation of therapy (89%), recording prior to antiarrhythmic therapy (84%) and quantification of well-known arrhythmias were the most successful indications of HM. The tremendous daily variability of infrequent symptoms or arrhythmias were the main causes for unsatisfactory results. A successful HM led predominantly to therapeutic consequences (begin, continuation, change or withdrawal of anti-arrhythmic drugs). In 25% HM was not followed by further therapeutic or diagnostic consequences, so that the indication for the HM should be reevaluated! Diagnostic consequences included repeated HM, ECG-Telephone-Transmission consequences heart catheterisation or electrophysiological procedures. In summary the Holter method satisfies the physician's demands if the expectations do not exceed the limitations of the method.