The use of external event monitoring (web-loop) in the elucidation of symptoms associated with arrhythmias in a general population

Objective To correlate arrhythmic symptoms with the presence of significant arrhythmias through the external event monitoring (web-loop). Methods Between January and December 2011, the web-loop was connected to 112 patients (46% of them were women, mean age 52±21 years old). Specific arrhythmic symptoms were defined as palpitations, pre-syncope and syncope observed during the monitoring. Supraventricular tachycardia, atrial flutter or fibrillation, ventricular tachycardia, pauses greater than 2 seconds or advanced atrioventricular block were classified as significant arrhythmia. The association between symptoms and significant arrhythmias were analyzed. Results The web-loop recorded arrhythmic symptoms in 74 (66%) patients. Of these, in only 14 (19%) patients the association between symptoms and significant cardiac arrhythmia was detected. Moreover, significant arrhythmia was found in 11 (9.8%) asymptomatic patients. There was no association between presence of major symptoms and significant cardiac arrhythmia (OR=0.57, CI95%: 0.21-1.57; p=0.23). Conclusion We found no association between major symptoms and significant cardiac arrhythmia in patients submitted to event recorder monitoring. Event loop recorder was useful to elucidate cases of palpitations and syncope in symptomatic patients.

研究目的 本研究旨在通过外置事件监测（web-loop，网络环路式监测仪），探讨心律失常症状与显著性心律失常检出情况之间的关联。
研究方法 2011年1月至12月期间，共纳入112例患者接受web-loop（网络环路式监测仪）监测，其中女性占比46%，患者平均年龄为52±21岁。本研究将监测期间出现的特异性心律失常症状定义为心悸、先兆晕厥与晕厥；将室上性心动过速、心房扑动/心房颤动、室性心动过速、长间歇≥2秒或高度房室传导阻滞归类为显著性心律失常。随后对症状与显著性心律失常之间的关联进行统计学分析。
研究结果 本研究中，74例（66%）患者通过web-loop监测记录到心律失常相关症状。其中仅14例（19%）患者检出症状与显著性心律失常之间存在关联。此外，11例（9.8%）无症状患者检出了显著性心律失常。经分析，主要症状的出现与显著性心律失常之间并无关联（优势比OR=0.57，95%置信区间CI：0.21~1.57；p=0.23）。
研究结论 本研究显示，接受事件记录仪监测的患者中，主要症状与显著性心律失常之间并无关联。事件环路记录仪可有效明确症状性患者的心悸与晕厥病因。