Pitfalls im Langzeit-EKG

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

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