Utility of event loop recorders for the management of arrhythmias in young ambulatory patients

Martinez, Thelmo; Sztajzel, Juan

doi:10.1016/j.ijcard.2003.11.004

Cited by 17 publications

(2 citation statements)

References 9 publications

(3 reference statements)

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“…Short lasting episodes should be difficult to be recorded, in these cases cardio-call and trans-telephonic transmission represent useful techniques to obtain SVT demonstration [28]. Rarely loop-recorder is required for evaluation of symptomatic patients especially with syncope in whom others diagnostic technique failed to document arrhythmias [29]. The disadvantages of loop-recorder are: invasivity and economic cost.…”

Section: Diagnostic Techniquesmentioning

confidence: 99%

Characterization of Supraventricular Tachycardia in Infants: Clinical and Instrumental Diagnosis

Vignati

Annoni

2008

CPD

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Supraventricular tachycardia (SVT) is the most common symptomatic arrhythmias in children. Re-entry tachycardias are the most common form, on the contrary automatic tachycardias are relatively rare. There are four types or re-entry: along anomalous pathway with bi-directional (Wolff-Parkinson-White) or unidirectional conduction, intranodal re-entry, intra-atrial re-entry that is common after surgical procedure, and finally the uncommon sinus node re-entry. Automatic tachycardias may be atrial or junctional. The different types of tachycardia have a different incidence according to the age: in the first year of age re-entry along anomalous pathway is the dominant form, while intranodal reentry becomes common during adolescence. The age at the beginning of tachycardia is important for long term prognosis. When SVT starts in the first months of life it disappears in 80% of cases within the first year of life; on the contrary, if tachycardia starts later spontaneous remission is detected in only 15%-20% of patients. In infancy heart failure is the more common presenting symptom, thereafter palpitations become the principal cause of recognition of SVT. Syncope is reported in about 8% of cases and in another 15% usually neonates and infants, the SVT has an occasional detection. Electrocardiogram (ecg) usually allows the precise diagnosis of various types of SVT, and every effort should be made to record ecg during tachycardia. The parameters that should be evaluated are: heart rate, P wave axis, PR and RP interval, and finally presence or absence of AV block. Short lasting episodes should be difficult to be recorded; in these cases cardio-call and trans-telephonic transmission represent useful techniques to obtain SVT demonstration. Patients with SVT require a complete evaluation with others diagnostic techniques: echocardiogram, Holter monitoring, stress test, that should be chosen according the type of tachycardia. Electrophysiologic evaluation is now rarely performed for diagnostic purpose; trans-esophageal atrial stimulation being less invasive than intracardiac evaluation is more extensively employed when diagnosis of SVT is uncertain. Transesophageal stimulation is useful in the following situations: 1) evaluation of patients with symptoms suggestive of paroxistic tachycardia but without ecg documentation, 2) to assess the mechanism responsible for re-entry tachycardia: macro re-entry versus intranodal re-entry 3) to evaluate characteristics of anomalous pathway with bi-directional conduction, and 4)to terminate re-entrant SVT.

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Section: Diagnostic Techniquesmentioning

confidence: 99%

Characterization of Supraventricular Tachycardia in Infants: Clinical and Instrumental Diagnosis

Vignati

Annoni

2008

CPD

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“…32,35 This finding is not really surprising, since symptoms have been proven to have a poor correlation with AF in many studies. [36][37][38][39] Thus, REVEAL AF, a somewhat larger and longer trial than PREDATE AF or ASSERT-II, confirmed a significant incidence of previously undiagnosed AF in a group of patients identified demographically to be at-risk for both AF and stroke, in whom a history of AF was absent and no previously implanted pacemaker/ICD was present. The at-risk populations studied in REVEAL AF, PRE-DATE AF, and ASSERT-II are a common group of patients encountered in clinical practice.…”

Section: Prevalence Of Subclinical Atrial Fibrillation Using An Implamentioning

confidence: 94%

When Silence Isn’t Golden: The Case of “Silent” Atrial Fibrillation

Reiffel

2017

J Innov Cardiac Rhythm Manage

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ABSTRACT. Silent atrial fibrillation (AF) is common. In some patients, it is the only manifestation of AF, while in others, the AF may be symptomatic or both symptomatic and asymptomatic. Regardless, however, to date, the significance, detection, and management considerations for silent AF have been incompletely elucidated. This current study aimed to review, for both the current clinician and investigator, considerations and attitudes and the ongoing studies, respectively, with respect to silent AF. The methods used were a literature review and personal trial and clinical experience; the frequency of silent AF, concerns regarding silent AF, methods to detect silent AF, and prospective trials focused on the detection and management of silent AF were considered. The results of the literature search indicated that recently conducted relevant trials, such as PREDATE AF, ASSERT-II, and REVEAL AF, have shown that silent AF is frequent in patients with risk markers for AF and stroke in whom no prior AF history is present, and in whom no pacemaker or implantable cardioverter-defibrillator implantations have been previously performed. Furthermore, the GLORIA-AF Registry has reported the observance of more permanent AF and more prior strokes in asymptomatic patients. Ongoing trials such as ARTESiA and NOAH-AFNET 6 are expected to clarify the benefits and risks of oral anticoagulation in patients with silent AF. At present, when silent AF is detected in patients with stroke risk markers, most practitioners initiate an anticoagulation regimen.

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Palpitations

2012

Evidence‐Based Emergency Care

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Utility of event loop recorders for the management of arrhythmias in young ambulatory patients

Cited by 17 publications

References 9 publications

Characterization of Supraventricular Tachycardia in Infants: Clinical and Instrumental Diagnosis

Characterization of Supraventricular Tachycardia in Infants: Clinical and Instrumental Diagnosis

When Silence Isn’t Golden: The Case of “Silent” Atrial Fibrillation

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