Guidelines for ambulatory electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Ambulatory Electrocardiography).

Detection of Myocardial Ischemia With a Computer-Assisted 12-lead 24-hour ECG Monitoring System (EAGLE) in Patients With Suspected Unstable Angina

“…The relatively high detection rate [83/161 (51.6%)] of the Holter system compared with the EAGLE system in the patients with vasospastic angina shows that the Holter system is a good tool for establishing the diagnosis, as recommended by the ACC/AHA Task Force. 35 However, the low detection rate [18/68 (26.5%)] with the Holter system in patients with organic stenosis indicates that myocardial ischemia should be reevaluated with more sophisticated new devices in future.…”

Ambulatory Electrocardiographic Monitoring

“…The ACC/AHA Task Force considered performing an AECG to determine whether palpitations, syncope, or dizziness are due to cardiac arrhythmia a class I indica tion [6], Performing an AECG to determine whether shortness of breath, chest pain, or fatigue are due to a cardiac arrhythmia was considered a class II indication…”

“…Accelerated analysis by a pro cessor-technician interface with audiovisual superim posed ECG presentation analysis is performed by the United Medical CT-240, Marquette 8000, CardioData Mk 3, Avionics Trendsetter, Hittman Compuscan III, ICR 6201, and Oxford Medilog 2 analysis systems [1], Manual analysis of miniaturized ECG complexes is per formed by the Zymed and American Edwards Elimina tor analysis systems [1]. Real-time analysis by the Holter recorder is performed by the Circadian Circamed, Datamedix Pecgasys, and Aegis medical analysis systems [6], Walter et al [7] found by AECG arrhythmias ac counting for the symptoms of cerebral ischemia in 10 of 39 patients (26%). Tzivoni and Stern [8] found by AECG arrhythmias causing symptoms of cerebral ischemia I use for my studies the CardioData Mk 3 computer system which performs arrhythmia, ST-segment, and pacemaker analysis and costs approximately $ 94,000 which were relieved by a permanent pacemaker in 12 of 110 patients (11%).…”

“…The ACC/AHA Task Force con sidered as class I indications for performing an AECG to evaluate pacemaker function the following: evaluation of paroxysmal symptoms, detection of myopotential inhi bition and pacemaker-mediated tachycardia, and evalu ation of antitachycardia pacing device function and rate-responsive physiologic pacing function [6], Class II indications for performing an AECG were the following: routine pacemaker follow-up evaluation, evaluation of atrial and/or ventricular sensing and pacing immediately after implantation, evaluation of percent of time pace maker is functioning and utilized, and evaluation of ven tricular rate and supraventricular arrhythmias in pa tients with implanted defibrillators [6], A 24-hour AECG should be obtained to assess the efficacy of antiarrhythmic therapy before and during treatment. Because of the marked spontaneous variation in the number and complexity of VPBs that may occur in an individual patient [17][18][19][20], I favor as drug efficacy a reduction in the frequency of VPBs of at least 75% and a reduction in the frequency of nonsustained ventricular tachycardia by at least 90% when comparing the preand posttreatment 24-hour AECGs [21].…”

“…The ACC/AH A Task Force considered as class I indi cations performing AECG for assessment of efficacy of antiarrhythmic therapy patients with baseline high fre quency, reproducible, sustained VPBs, supraventricular arrhythmias, or ventricular tachycardia [6], Class II indi cations were patients with known episodic or reverted atrial fibrillation to evaluate efficacy of antiarrhythmic therapy, patients with VPBs of variable frequency and complexity or relatively infrequent brief salvos of ven tricular or supraventricular arrhythmias, patients with Wolff-Parkinson-White syndrome, and assessment of proarrhythmic effects, tachyarrhythmias, bradyarrhythmias, and conduction disturbances related to drug ad ministration [6].…”