Semnificatia aritmiilor decelate pe Holter ECG

Semnificatia aritmiilor decelate pe Holter ECGMonitorizarea holter ECGManagementul pacientului cu palpitatiiSemnificatia fibrilatiei atriale paroxistice de scurta durataScurt istoric1947- 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 dimensiunile1962-primul dispozitiv comercial fabricat de Lab. Del Mar Engineering

The classification of the ambulatory ECG monitoring systems (I.N.Posokhov, 2012)Classification by:Optionsthe period of monitoring24h;48h;weeks to months.the means of recordingcontinuous recording;intermittent recording: a) loop recording; b) event recording.the device location during monitoringimplanted recorder;wearable recorder.the number of ECG-channels1;2;3;12.the electrodes/leads characteristicsexternal 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 GuidellinesClass IEvaluation of pre-syncope, syncope, episodic dizziness in patients without obvious causeEvaluation of palpitations that are unexplained and recurrentAssessment of response to antiarrhythmic drug in patients with reproducible and frequent arrhythmiaEvaluation of palpitations or other symptoms in patients with pacemakers to assess device function and to assist in programming rate responsive features and mode switchingAssessment of potential device failure when interrogation of device is not sufficientAssessment of medication therapy in patients with devicesClass IIaDetection of proarrhythmic response to antiarrhythmic drugs in high-risk patientsClass IIb Unexplained episodic shortness of breath, chest pain, or fatigue Assessment of neurological events in patients with possible atrial fibrillation or flutter

Patients with pre-syncope, syncope, or dizziness which continues despite treatment of another cause which is more likely than arrhythmiaAssessment of rate control in atrial fibrillationDocumentation of arrhythmia (symptomatic or asymptomatic) during outpatient treatmentPost implantation evaluation in patients with pacemaker or ICD as alternative or adjunct to in-hospital telemetryEvaluation of supraventricular tachycardia rate in patients with ICDsClass IIIEvaluation in patients with pre-syncope, syncope, dizziness, or palpitations with other identified causesAssessment of cerebrovascular events without other evidence for arrhythmiaAssessment of device malfunction when underlying cause can be made by other meansFollow up in asymptomatic patientsIndications for Ambulatory Electrocardiography - AECG GuidellinesClass IEvaluation of pre-syncope, syncope, episodic dizziness in patients without obvious causeEvaluation of palpitations that are unexplained and recurrentAssessment of response to antiarrhythmic drug in patients with reproducible and frequent arrhythmiaEvaluation of palpitations or other symptoms in patients with pacemakers to assess device function and to assist in programming rate responsive features and mode switchingAssessment of potential device failure when interrogation of device is not sufficientAssessment of medication therapy in patients with devicesClass IIaDetection of proarrhythmic response to antiarrhythmic drugs in high-risk patientsClass IIb Unexplained episodic shortness of breath, chest pain, or fatigue Assessment of neurological events in patients with possible atrial fibrillation or flutter

Patients with pre-syncope, syncope, or dizziness which continues despite treatment of another cause which is more likely than arrhythmiaAssessment of rate control in atrial fibrillationDocumentation of arrhythmia (symptomatic or asymptomatic) during outpatient treatmentPost implantation evaluation in patients with pacemaker or ICD as alternative or adjunct to in-hospital telemetryEvaluation of supraventricular tachycardia rate in patients with ICDsClass IIIEvaluation in patients with pre-syncope, syncope, dizziness, or palpitations with other identified causesAssessment of cerebrovascular events without other evidence for arrhythmiaAssessment of device malfunction when underlying cause can be made by other meansFollow up in asymptomatic patientsManagementul pacientului cu palpitatiiPalpitatiile reprezinta o senzatie neplacuta de pulsatie sau miscare in piept si/sau ariile invecinate.Reprezinta un simptom foarte frecvent intalnit in populatia generala16% dintre toate cauzele de prezentare la MFA 2-a cauza de prezetare la caardiolog (dupa durerea in piept)Clasificare etiologica:Aritmii cardiace Boli cardiace structurale Tulburari psihosomaticeBoli sistemiceEfecte adverse ale medicamentelor sau drogurilorStudiu- aritmii decelate Managementul pac cu palpitatiiSchema

Different monitoring metods to detect AF