[Long-term ECG as a decision aid in indications for a permanent pacemaker].

Holter-monitoring is an excellent tool for diagnosing temporary rhythm-disturbances especially as regards brady- and tachycardias which may benefit from pacemaker-implantation. In bradycardias AV-blocks of 2nd and 3rd degree which occur only temporarily as well as bi- and trifasciculate blocks with occasional bradycardias can be analysed by Holter-monitoring. The type of pace-maker can be determined more easily by knowing whether there is temporary atrial flutter or fibrillation since DDD-pacers are not indicated in such cases. In tachycardias Holter-monitoring is also very helpful especially in detecting premonotory extrasystoles which occur occasional or in couplets or triplets or with an R- or T-phenomenon. Early treatment with antiarrhythmics eventually combined with a pacemaker can give good results for the patient. In some cases an external pacer combined with antiarrhythmics can be used as a test before permanent implantation will be performed. Also the type of antitachycardia-pacers can be determined more easily by knowing the results of Holter-monitoring.