Event recorder for etiologic diagnosis of sporadically occurring cardiac complaints and symptoms

Rarely and transient occurring arrhythmia, palpitation, dizziness, syncopes and chest pain frequently cause symptoms and complaints to patients with c ongenital cardiac defects. The reliable identification of their pathogenesi s is often difficult. The study presented here demonstrates the impact of a n event recorder for enlightening sporadically occurring complaints and sym ptoms. Fifty patients (age between 11 and 70 years, median 27 years) were examined with an event recorder (King of Hearts Express(R), Instromedix, Hillsboro, USA). The patients were referred to an outpatient clinic for congenital ca rdiac defects in order to clarify unexplained arrhythmia, palpitations, diz ziness, or syncope. Included were patients above 10 years of age. Previous cardiac studies (including EGG, exercise-EGG, Holter-Monitoring) were non-d iagnostic in all. Altogether 227 ECGs had been recorded. 95% of them were of diagnostic quali ty. The event recorder afforded ambulatory monitoring and the median durati on of monitoring was 22.5 days. The average number of registered events was 4.5 +/- 3.8. In 24% of the patients (n = 12) diagnostic and/or therapeutic al consequences resulted: electrophysiological examination (n = 5), drug tr eatment (n = 4) and pacemaker implantation (n = 3). The event recorder is an important and highly effective tool in diagnosing sporadical transient symptoms and complaints, especially arrhythmias.