Transtelephonic electrocardiographic monitoring for the detection and treatment of cardiac arrhythmias.

TTEM as a means for ambulatory arrhythmia detection and management of cardiac patients has demonstrated the potential for considerable clinical utility. Because it is easy to use, relatively inexpensive, and highly effective in aiding in the diagnosis of various cardiac arrhythmias, it may be a preferred mode of surveillance for a number of cardiac patients of all ages. TTEM is presently used most widely for pacemaker followup. TTEM can be used alone and in conjunction with Holter monitoring in the management of cardiac arrhythmias, and has lately become a recognized tool in the followup of patients with ischemic heart disease, especially post-myocardial infarction patients. It is important to emphasize that TTEM is only one part of an overall approach to ambulatory monitoring that also includes Holter monitoring and exercise testing. It must be noted, however, that the studies comparing the efficacy of TTEM with that of other surveillance methods are few and consist of only a relatively small number of patients. Therefore, it would be premature to draw conclusions regarding the ultimate role of TTEM and its comparative value in the routine management of most cardiac arrhythmia problems. However, available data do support an increasing role for these systems in the future.