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Utility of Outpatient Cardiac Telemetry Monitoring

2015; Lippincott Williams & Wilkins; Volume: 47; Issue: 5S Linguagem: Inglês

10.1249/01.mss.0000479198.91063.c7

1530-0315

faith Bangawan, Elizabeth A. Stephenson, Paweena Chungsomprasong, Christine Chiu-Man,

Healthcare Technology and Patient Monitoring

PURPOSE: Chest pain, syncope, dizziness and palpitations during unstructured physical activity, exercise training or sedentary activity are common referrals to pediatric cardiologists. However, due to the sporadic nature of a child’s symptoms, exercise testing may not satisfy the cardiac evaluation. Outpatient transtelephonic mobile cardiac monitoring is the next step in evaluation used by the SickKids cardiac clinic. The objective of this study is to assess the yield of pathological arrhythmia diagnoses in children and teenagers with and without congenital heart disease. METHODS: Retrospective data collection and analysis of all outpatients at our cardiac clinic who were prescribed transtelephonic event monitoring during the year of 2010. RESULTS: 171 patients (ages 14.1 +/- 3.1 years, 50.6% female, 49.4% male) were loaned monitors for a duration of 43 +/- 19.5 days. Out of 171 patients, 112 sent at least 1 transtelephonic recording. Of this group, 55.4% of symptoms were experienced during sedentary activities whereas 29.5% of of episodes were during physical activity such as sports or walking. 15.2% of the recordings sent did not include an activity statement. A positive arrhythmia yield of 18.8% was detected amongst patients who sent a recording. Of the positive yield, 66.7% were captured during physical activity. 10 of these patients underwent subsequent electrophysiology studies. CONCLUSIONS: Documentation of arrhythmia is difficult in children and teenagers, particularly in those who only present with occasional symptoms. For this reason and potential cost-effectiveness, transtelephonic event monitoring should be considered in conjunction with or prior to stress testing.