Event Monitoring

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Contents 1 More Specific Terms 2 Introduction 3 Indications 4 Procedure 5 Interpretation 6 Notes 7 More General Terms 8 Additional Terms 9 References

More Specific Terms

• implanted ECG recorder

Introduction

• Similar to HOLTER, but is worn for longer periods of time. Diagnostic yield of event recording is generally greater than that of HOLTER monitoring.

Indications

• infrequent symptomatic brief arrhythmias
• recurrent syncope

Procedure

• continuous electrocardiographic monitoring
• before or after symptoms, the patient may trigger the memory loop*
• when activated, the preceding 30-120 seconds of ECG activity are recorded; several minutes of post triggering may be recorded
• loop recording allows for weeks to months# of continuous surveillance

Interpretation

• Results are limited by:

• frequency of syncopal episodes
• patient's failure to trigger recorder

• Definitive results (i.e. event with or without dysrhythmia is obtained about 30% of tests).
• * The patient must trigger the device to capture the ECG tracing.
• # Generally, devices are provided to patients for a 30 day period.
  
• Advantages: (not mentioned above)

• captures arrhythmia onset

• Disadvantages

• ECG leads limit patien activity

Notes

• apparently there exist event recorders that are small, pocket- sized recorders held to the chest when symptoms are present; these are not useful in evaluation of syncope since the patient awakens to activate the device when the symptoms have resolved
• it is the loop recording feature that allows event recording to capture event(s) within the two minutes prior to patient- initiated device activation

More General Terms

• electrophysiologic measurement

Additional Terms

• HOLTER

References

- Medical Knowledge Self Assessment Program (MKSAP) 11, 15 American College of Physicians, Philadelphia 1998, 2009 event monitoring (event recording, loop recording)