Abstract
The long-term ECG is one of the basic diagnostic methods in cardiovascular medicine in addition with rest and exercise ECG. For the diagnostic of symptomatic arrhythmias the long-term ECG plays a crucial role and might often lead to therapeutic consequences. The method itself was established by Holter 47 years ago. In the following years the recorders and their analysing stations were further developed to computerized hardware and software solutions and their availability is standard. In addition, the computerization generated a variety of new qualitative and quantitative analysis opportunities but their clinical relevance was sometimes contradictorily discussed. Different methods e. g. the heart rate analysis, the implementation of the automated time/frequency domain analysis, differentiated analysis of the QT duration and QT dispersion or the Heart rate turbulence were found in several studies as prognostic marker f for i. e. sudden cardiac death. Due to controversial results in several studies, these methods were not implemented in the guidelines for implantation of defibrillators. However, the typical antibradycardic and antitachycardic device therapy often results in a broad variety of different „Pitfalls” (e. g. stimulation and sensing disorders).
Literatur
-
1
Sauer G, Andresen D, Cierpka R, Lemke B, Mibach F, Perings C, Vaerst R.
Position paper to the taking of quality controls for resting, exercise, and long-term-ECG.
Z Kardiol.
2005;
94
844-857
-
2
Holter N J.
New method for heart studies.
Science.
1961;
134
1214-1220
-
3
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology .
Heart rate variability. Standards of measurement, physiological interpretation, and clinical use.
Eur Heart J.
1996;
17
354-381
-
4
Watanabe E, Arakawa T, Uchiyama T. et al .
Prognostic significance of circadian variability of RR and QT intervals and QT dynamicity in patients with chronic heart failure.
Heart Rhythm.
2007;
4
999-1005
-
5
Schmidt G, Malik M, Barthel P. et al .
Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction.
Lancet.
1999;
24; 353 (9162)
1390-1396
-
6
Moss A J, Zareba W, Hall W J. et al .
Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.
N Engl J Med.
2002;
346
877-883
-
7
Bardy G H, Lee K L, Mark D B. et al .
Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.
N Engl J Med.
2005;
352
225-237
-
8
Jung W, Andresen D, Block M, Bocker D, Hohnloser S H, Kuck K H, Sperzel J.
Guidelines for the implantation of defibrillators.
Clin Res Cardiol.
2006;
95
696-708
-
9
Seidl K, Schuchert A, Tebbenjohanns J, Hartung W.
Commentary on the guidelines the diagnosis and the therapy of syncope - the European Society of Cardiology 2001 and the update 2004.
Z Kardiol.
2005;
94
592-612
Dr.-Ing. Thomas Rauwolf
Prof. Dr. med. Ruth H. Strasser
Herzzentrum Dresden, Universitätsklinik an der Technischen Universität Dresden
Fetscherstr. 76
01307 Dresden
Email: rauwolf@rcs.urz.tu-dresden.de
