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Efficacy of diagnostic tools for detecting cardiac arrhythmias: systematic literature search Hoefman E; Bindels PJ; van Weert HCNeth Heart J 2010[Nov]; 18 (11): 543-51BACKGROUND/OBJECTIVES: Symptoms suggestive of cardiac arrhythmias are a challenge to the diagnosis. Physical examination and a 12-lead ECG are of limited value, as rhythm disturbances are frequently of a paroxysmal nature. New technologies facilitate a more accurate diagnosis. The objective of this study was to review the medical literature in an effort to define a guide to rational diagnostic testing. METHODS: Primary studies on the use of a diagnostic tool in the evaluation of palpitations were searched in MEDLINE, and EMBASE with an additional reference check. RESULTS: TWO TYPES OF STUDIES WERE FOUND: descriptive and experimental studies, which compared the yield of two or more devices or diagnostic strategies. Holter monitors seemed to have less diagnostic yield (33 to 35%) than event recorders. Automatically triggered recorders detect more arrhythmias (72 to 80%) than patient-triggered devices (17 to 75%). Implantable devices are used for prolonged monitoring periods in patients with infrequent symptoms or unexplained syncope. CONCLUSION: The choice of the device depends on the characteristics of the symptoms and the patient. Due to methodological shortcomings of the included studies no evidence-based diagnostic strategy can be proposed. (Neth Heart J 2010;18:543-51.).ä |
