VOLUNTARY SEQUENTIAL AMBULATORY RECORDING FOR ARRHYTHMIA DETECTION - A MULTICENTER STUDY OF 1287 SYMPTOMATIC PATIENTS

Voluntary sequential ambulatory recording is a diagnostic method of re cording per-critical electrocardiographs in symptomatic patients with the aid of a portable solid-state technology recorder. In order to ass ess the value of this technique in the detection of arrhythmias, a mul ticenter study was performed in 1 287 symptomatic patients suspected o f having paroxysmal arrhythmias (palpitations in 86.5% of cases). The quality of the sequential ambulatory recording was judged to be good i n 54.9 % and mediocre in 40.2 % of cases : only 4.9 % of recordings we re uninterpretable. This technique allowed identification of a cardiac arrhythmia related to symptoms in 42.5 % of the 1 091 cases which wer e analysed ; sustained supraventricular tachycardia (11.7 %), ventricu lar extrasystoles (14.9 %) and simple sinus tachycardia (9.5 %) were t he principal abnormalities. The per-critical recording was negative in 57.5 % of patients, suggesting a purely functional origin of symptoms in these cases. Atrial fibrillation was more common in hypertensive p atients (11.3 % vs 5.5 % in normotensive, p < 0.01) as were ventricula r extrasystoles (23.1 % vs 13 % in normotensives, p < 0.001). Voluntar y sequential ambulatory recording seems to be a technique well adapted to the detection of symptomatic arrhythmias and a useful complement t o Holter recording.