Ambulatory ECG Monitoring

Excerpt

Cardiovascular diseases substantially contribute to the burden of morbidity and mortality worldwide. Arrhythmias significantly contribute to cardiovascular morbidity; most cardiac arrests and sudden cardiac deaths are secondary to arrhythmias. The rapid, accurate diagnosis of dysrhythmias is essential to effectively treat patients, prevent complications, and optimize patient outcomes. Electrocardiography (ECG) is a foundational diagnostic tool offering valuable insight into the function of the cardiac conduction system. However, traditional ECG recordings in clinical settings provide only a snapshot of cardiac activity, limiting their ability to capture intermittent or subtle abnormalities.

Ambulatory ECG monitoring enables continuous and prolonged surveillance of a patient's cardiac rhythm in their natural environment. Ambulatory ECG monitoring employs portable devices to record and analyze cardiac electrical activity over extended periods. Continuous, prolonged monitoring is more likely to detect transient or infrequent cardiac events that may go unnoticed during short-term recordings. The prototype of ambulatory ECG monitoring is the Holter monitor, invented in 1961. Ambulatory ECG monitoring has continually advanced; multiple devices are now available to improve diagnostic yield. Prolonged ambulatory ECG monitoring is uniquely poised to capture elusive arrhythmias, evaluate the efficacy of antiarrhythmic therapies, and assess overall cardiovascular health.

This activity reviews the various ambulatory ECG monitoring devices currently in clinical use and the indications, critical findings, and clinical significance of this testing modality.