Operational areas

The conventional long-term electrocardiogram over 24 hours serves mainly the recognition and quantification of heartbeat disturbances with patients with a well-known heart illness or with symptoms, which could be caused by rhythm disturbances. In addition count heart lawns, Herzstolpern, swindle attacks, faint accumulations (Synkopen) and temporary paralysis features (TIA).

With patients with forecourt flares or forecourt flutter in the LZ-EKG episodes of the rhythm disturbance are often uncovered, which were not noticed particularly at night by the patient. After a cardiac infarct or with heart muscle illnesses likewise unnoticed life-threatening rhythm disturbances can be discovered in particular with strongly reduced pumping strength of the heart, which require a special treatment.

If the symptoms mentioned arise not daily, also the 24-Stunden-Langzeit-EKG remains often without trailblazing findings. In these cases a Event recorder can contribute often to prove or exclude heartbeat disturbances as a cause. Now and then in this way also panic attacks and fear disturbances can be assigned to a rhythm disturbance as consequences.

In principle also an analysis of the ST-distances is possible for uncovering of blood circulation disturbances of the heart muscle with substantial temporal expenditure and at least three standardized derivatives. Due to the reduced force of expression of in such a way raised findings and improved other possibilities this analysis is only accomplished in exceptional cases.

Technology

Long-term electrocardiogram

The 24-Stunden-LZ-EKG is transferred over three to six electrodes stuck on the thorax continuously to a cartridge or a permanent memory recorder, which is carried at the belt or around the neck. The older similar to noting tape cartridge devices resemble Walkman and weigh about 150-220 gram. Modern devices store digitally on non removable disks, CompactFlash memory cards or comparable storage media. They weigh about 100-120 gram and permit one recording duration of up to one week. After end of the recording the data are computer-assisted evaluated, whereby on the average about 100,000 heart actions per 24 hour must be analyzed.

Event recorder

The use of the terms Event recorders and loop recorders is not uniform. Event recorders often small digital recording devices are called of the size of a folding mobile phone, which is carried by the patient several weeks without skin contact. When the occurrence symptoms such as heart lawns or Herzstolpern he presses the equipment on the skin in the chest range and releases an electrocardiogram recording over 30-60 seconds. Loop recorders however note the ELECTROCARDIOGRAM over skin electrodes durably, delete it however after usually 30 seconds again. Only pre-programmed special electrocardiogram events and of the patient by depressing the key marked electrocardiogram episodes are durably stored.

Frequently also both forms of the intermittent electrocardiogram recording under the term Event Recording are together seized. For instance since the turn of the century by new recording and transmission techniques a multiplicity of new Event recorders became available, whatever continued to improve the possibilities for the recording and therapy of very rare rhythm disturbances:

• Implantierte loop recorders can note electrocardiogram episodes over several years without considerable impairment of the patient, the inquiry of these recorders effected telemeterically. The devices themselves and the risk of the operational implantation are comparable to the cardiac pacemaker therapy with those.
• Special mobile phones with electrocardiogram electrodes can be taken up on the chest wall and be sent the current ELECTROCARDIOGRAM over the GSM net at an emergency call center. Before and after the transmission the usual voice communication can be used for description of symptom and for therapy references, if necessary can the center the place of residence of the patient determine and rescue forces alarm.
• A Bluebelt plastic chest belt mentioned with dry electrodes seizes the ELECTROCARDIOGRAM continuously and alarms with the occurrence of certain electrocardiogram events over a Bluetooth connection and a relay or mobile phone likewise via GSM net an emergency call center.

Related links

• Position paper for the execution of quality controls with resting, load and long-term electrocardiogram Dt. society for Kardiologie (2005, pdf 203 KB)
• Guidelines for the Event /Loop recorder Austrian Kardiologi total ones (2002, pdf 45 KB)

Articles in category "Long-term electrocardiogram"

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