A prospective randomized comparison of loop recorders versus Holter monitors in patients with syncope or presyncope
A prospective randomized comparison of loop recorders versus Holter monitors in patients with syncope or presyncope
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DOI：
10.1016/s0002-9343(03)00233-x
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发表时间：
2003-07-01
影响因子：
5.9
通讯作者：
Skanes, AC
中科院分区：
文献类型：
--
作者：
Sivakumaran, S;Krahn, AD;Skanes, AC
背景：晕厥或晕厥先兆的初始治疗通常涉及使用动态心电图监测仪进行短期心脏监测。循环记录器用于延长监测时间，以增加获得症状-节律相关性的概率。循环记录仪和 Holler 监护仪均常用，但尚未对它们的效用进行前瞻性比较。 方法：转诊至 Holler 监护仪或循环记录仪的晕厥或先兆晕厥患者被随机分配接受 48 小时 Holter 监护仪或循环记录仪 1 个月，作为初始诊断策略。如果初始策略不成功，则为患者提供替代策略的交叉治疗。 结果：100 名患有晕厥 (n = 21)、先兆晕厥 (n = 29) 或两者兼有 (n = 50) 的患者（平均 [+/-SD] 年龄，56 +/- 20 岁；44 名女性）入组。首先随机分配至外部循环记录仪的 49 名患者中，有 31 名 (63%) 发现或排除了心律失常，而最初分配至动态心电图监测的 51 名患者中有 12 名 (24%) (P
BACKGROUND: The initial management of syncope or presyncope typically involves short-term cardiac monitoring using a Holter monitor. A loop recorder is used to extend the period of monitoring to increase the probability of obtaining a symptom-rhythm correlation. Loop recorders and Holler monitors are both used commonly, but their utility has not been compared prospectively.METHODS: Patients with syncope or presyncope referred for a Holler monitor or a loop recorder were assigned randomly to receive either a 48-hour Holter monitor or a loop recorder for 1 month as an initial diagnostic strategy. If the initial strategy was unsuccessful, patients were offered crossover to the alternate strategy.RESULTS: One hundred patients (mean [+/-SD] age, 56 +/- 20 years; 44 women) with syncope (n = 21), presyncope (n = 29), or both (n = 50) were enrolled. Of the 49 patients assigned randomly to an external loop recorder first, 31 (63%) had an arrhythmia identified or excluded, versus 12 (24%) of 51 patients assigned to a Holter monitor initially (P