OCCURRENCE OF ARRHYTHMIAS IN GENERAL-PRACTICE

Objective - To study the occurrence and distribution of arrhythmias in patients with symptoms possibly caused by arrhythmias, in order to su pport the diagnostic process in general practice. Design - From 1989-1 991 all patients who consulted their general practitioner with symptom s or signs possibly indicating an arrhythmia had a transtelephonic ele ctrocardiogram, which was sent to the Department of Cardiology for int erpretation. Setting - 20 Dutch general practices, serving a populatio n of nearly 50 000 inhabitants. Subjects - A total of 868 patients wer e included in the study. Results - An arrhythmia was documented by ECG in 32% of the patients. Of these, 31% clinically more relevant arrhyt hmias needed medical attention. An incidence of 2.6 arrhythmias per 10 00 listed patients was calculated. There was a highly positive correla tion between the occurrence of arrhythmias and age. Relatively more ar rhythmias were seen in men, in patients with occasional findings, and when there were symptoms that possibly indicated haemodynamic imbalanc e. Conclusion - Clinically relevant arrhythmias can be detected in gen eral practice with 12-lead ECG recording in a significant proportion o f patients with symptoms and physical findings suggesting an arrhythmi a. The distribution of arrhythmias described in this study can help ge neral practitioners in their diagnostic management.