Lessons from ambulatory electrocardiography.
نویسنده
چکیده
In the 1950s Norman "Jeff' Holter, the American physicist, developed and gave his name to the technique of recording physiological signals from ambulant patients.' Holter monitoring has now come to be synonymous with ambulatory electrocardiography. In hospital practice the term ECG (electrocardiogram) taping is used, often with the prefix 24 hours to indicate the usual duration of the record. Ambulatory electrocardiography is the preferable term, however, because it covers variations in the way electrocardiographic signals are recorded (for example, by radiotelemetry or through the telephone rather than, as is usual, on to a tape cassette) and those monitors that are geared to record only when the patient experiences symptoms and then triggers the "event recording" button on the machine. The commonest problem in interpreting ambulatory electrocardiographic records is recognising the signals that are due to artefact generated from poor contact between the skin and the recording electrode. Most artefacts are easily identified by their high frequency but others mimic arrhythmias such as ventricular tachycardia. Machine artefacts may also mislead-for example, slowing of the cassette may erroneously suggest bradycardia. Thus the first lesson of interpreting the results of ambulatory electrocardiography is to be wary offindings which do not fit with the clinical picture. It is also important to appreciate the extent to which electrocardiographic recordings vary in otherwise normal people, the poor correlation between the symptoms and arrhythmias, the changes that may lead to sudden death, and the signs of occult ischaemia.
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ورودعنوان ژورنال:
- British medical journal
دوره 291 6496 شماره
صفحات -
تاریخ انتشار 1985