DYNAMIC ELECTROCARDIOGRAPHY―REVIEW OF 100 CASES
Review of 100 cases of dynamic electrocardiogram (24-hour Holter monitoring ECG) reveals that the routine ECG which usually provides less than 1 minute of actual recording time was inadequate for the detection of arrhythmia in 59 of the 91 symptomatic patients. Syncope alone was the most frequent symptom noted in approximately one-third of the patients. In the group with demonstrated arrhythmia or significant changes in arrhythmia on 24-hour Holter recording the incidence of supraventricular arrhythmia was 30%, ventricular arrhythmia 38% and for sinus abnormalities and A-V block it was 32%. The most frequent arrhythmia in the ventricular arrhythmia group was uniform PYC (premature ventricular contraction) of more than 6 per minute (39%). None of PVC demonstrated R on T phenomenon nor subsequent ventricular fibrillation. Only 1 patient displayed a short run of ventricular tachycardia. Holter monitoring is a practical, noninvasive tool with demonstrated potential for increasing the accuracy of diagnosis in selected cardiovascular problems but it also possesses certain limitations as demonstrated by the fact that it failed to offer explanation for the symptoms in 14 of our patients.
