Cardiac monitoring for patients with palpitations

Figure 1 Main electrocardiographic monitoring devices available according to electrocardiogram recording duration and type and number of derivations. ¹While they prospectively register 30–60 s, they may be used repeatedly on a long-term basis. ECG: Electrocardiogram.

Figure 2 Example of an electrocardiogram trace obtained with an external loop recorders in a patient with palpitations. The beginning of a supraventricular tachycardia (SVT) is observed. A premature atrial beat that conducts with long PR seems to be the trigger of the SVT. This finding is highly suggestive of atrioventricular nodal re-entry tachycardia.

Figure 3 Example of an electrocardiogram tracing obtained with a Holter monitor with single-lead or multiple leads. A: A polymorphic trace is apparent with a single-lead record; B: After checking the other leads, the artifact can be easily identified.

Figure 4 Proposed general algorithm for the management of patients with palpitations of unknown etiology. ¹Consider only in selected patients. ELR: External loop recorder; ILR: Implantable loop recorder; ECG: Electrocardiogram.