SEMNIFICATIA

ARITMIILOR DECELATE
PE HOLTER ECG
Monitorizarea holter ECG
Managementul pacientului cu palpitatii
Semnificatia fibrilatiei atriale paroxistice de scurta durata

Scurt istoric
1947- Norman J. Holter a

inventat primul aparat portabil

ECG -Holter ECG (35 kg)
1957-publica primul studiu:
Radioelectrocardiography: a
new technique for
cardiovascular studies.
1961-reinventeaza aparatul
reducandu-i dimensiunile
1962-primul dispozitiv
comercial fabricat de Lab. Del
Mar Engineering

The classification of the ambulatory ECG

monitoring systems (I.N.Posokhov, 2012)
Classification by:

Options

the period of monitoring

24h;
48h;
weeks to months.

the means of recording

continuous recording;
intermittent recording: a) loop
recording; b) event recording.

the device location during

monitoring

implanted recorder;
wearable recorder.

the number of ECG-channels

1;
2;
3;
12.

the electrodes/leads
characteristics

external breast leads;

intracardiac electrode;
electrode built into device
body.

Holter ECG

Event recoder

Implantable loop recorders

Wireless EKG monitoring

Transtelephonic ECG monitoring

Indications for Ambulatory Electrocardiography - AECG Guidellines

Patients with pre-syncope, syncope, or

Class I
Evaluation of pre-syncope, syncope, episodic
dizziness in patients without obvious cause
Evaluation of palpitations that are unexplained and
recurrent
Assessment of response to antiarrhythmic drug in
patients with reproducible and frequent arrhythmia
Evaluation of palpitations or other symptoms in
patients with pacemakers to assess device
function and to assist in programming rate
responsive features and mode switching
Assessment of potential device failure when
interrogation of device is not sufficient
Assessment of medication therapy in patients with
devices
Class IIa
Detection
of
proarrhythmic
response
to
antiarrhythmic drugs in high-risk patients
Class IIb
Unexplained episodic shortness of breath, chest
pain, or fatigue
Assessment of neurological events in patients
with possible atrial fibrillation or flutter

dizziness which continues despite

treatment of another cause which is
more likely than arrhythmia
Assessment of rate control in atrial
fibrillation
Documentation of arrhythmia
(symptomatic or asymptomatic) during
outpatient treatment
Post implantation evaluation in patients
with pacemaker or ICD as alternative or
adjunct to in-hospital telemetry
Evaluation of supraventricular
tachycardia rate in patients with ICDs
Class III
Evaluation in patients with pre-syncope,
syncope, dizziness, or palpitations with
other identified causes
Assessment of cerebrovascular events
without other evidence for arrhythmia
Assessment of device malfunction when
underlying cause can be made by other
means
Follow up in asymptomatic patients

Indications for Ambulatory Electrocardiography - AECG Guidellines

Patients with pre-syncope, syncope, or

Class I
Evaluation of pre-syncope, syncope, episodic
dizziness in patients without obvious cause
Evaluation of palpitations that are unexplained
and recurrent
Assessment of response to antiarrhythmic drug in
patients with reproducible and frequent arrhythmia
Evaluation of palpitations or other symptoms in
patients with pacemakers to assess device
function and to assist in programming rate
responsive features and mode switching
Assessment of potential device failure when
interrogation of device is not sufficient
Assessment of medication therapy in patients with
devices
Class IIa
Detection
of
proarrhythmic
response
to
antiarrhythmic drugs in high-risk patients
Class IIb
Unexplained episodic shortness of breath, chest
pain, or fatigue
Assessment of neurological events in patients
with possible atrial fibrillation or flutter

dizziness which continues despite

treatment of another cause which is
more likely than arrhythmia
Assessment of rate control in atrial
fibrillation
Documentation of arrhythmia
(symptomatic or asymptomatic) during
outpatient treatment
Post implantation evaluation in patients
with pacemaker or ICD as alternative or
adjunct to in-hospital telemetry
Evaluation of supraventricular
tachycardia rate in patients with ICDs
Class III
Evaluation in patients with pre-syncope,
syncope, dizziness, or palpitations with
other identified causes
Assessment of cerebrovascular events
without other evidence for arrhythmia
Assessment of device malfunction when
underlying cause can be made by other
means
Follow up in asymptomatic patients

Managementul pacientului cu palpitatii

Palpitatiile reprezinta o senzatie neplacuta de pulsatie sau

miscare in piept si/sau ariile invecinate.

Reprezinta un simptom foarte frecvent intalnit in populatia
generala
16% dintre toate cauzele de prezentare la MF
A 2-a cauza de prezetare la caardiolog (dupa durerea in piept)

Clasificare etiologica:
Aritmii cardiace
Boli cardiace structurale
Tulburari psihosomatice
Boli sistemice
Efecte adverse ale medicamentelor sau drogurilor

Studiu- aritmii decelate

Sales

aritmii
2
3
4

Managementul pac cu palpitatii

Schema

Different monitoring metods to detect AF