Abstract：Objective To investigate the clinical value of remote monitoring system in diagnosing patients with arrhythmia and ST-T change.Methods A total of 78 patients with heart diseases or heart symptoms were undergone 12 lead electrocardiogram(ECG) and remote ECG monitoring examination; 42 out of 78 cases received Holter examination．The recall rate of remote ECG monitoring, 12 lead ECG and Holter in the diagnosis of arrhythmia and ischemic ST-T change was compared．Results There were significant differences in the detection of arrhythmia and ST-T changes between remote ECG monitoring and 12 lead ECG (79.5% vs 59.0%,P<0.05 for arrhythmia; 17.9% vs 7%, P<0.05 for ST-T change). There was no significant difference in the detection of arrhythmia and ST-T changes between remote ECG monitoring and 24-hour Holter （81.0% vs 71.4%,P>0.05 for arrhythmia; 23.8% vs 16.7%,P>0.05 for ST-T changes）. Among the 42 patients with Holter, 34 patients with arrhythmia were recorded by remote ECG monitoring while 30 patients with arrhythmia were recorded by Holter.No significant difference was found between these two methods(81.0％vs71.4%,P>0.05). 10 patients with ischemic ST-T change were recorded by remote ECG monitoring (23.8%), insignificantly different from that by ECG (7/42, 16.7%, P>0.05).Conclusion Compared with 12 lead ECG, remote ECG monitoring shows higher detection rate in diagnosing arrhythmia and ischemic ST-T changes. While compared with Holter, remote ECG monitoring failed to diagnose arrhythmia and ischemic ST-T changes.
顾敏，顾翔，何胜虎，孙磊，张晶，孙加斌. 比较远程心电监测与心电图、动态心电图在心律失常及心肌缺血中的诊断价值[J]. 实用心电学杂志, 2013, 22(2): 565-569.
GU Min，GU Xiang，HE Sheng-hu，SUN Lei，ZHANG Jing，SUN Jia-bin. Comparison of diagnostic value between remote ECG monitoring, 12 lead ECG and Holter in arrhythmia and myocardial ischemia. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2013, 22(2): 565-569.
\[1\] Lévy S, Boccara G, Dotto P, et al. A multicentre trial of the diagnostic value and cost of electrocardiography in symptoms suggesting arrhythmia with a new event recorder with transtelephonic transmission\[J\].Arch Mal Coeur Vaiss, 2004,97（2）:108-112.\[2\] Kouidi E, Farmakiotis A, Kouidis N, et al. Transtelephonic electrocardiographic monitoring of an outpatient cardiac rehabilitation programme\[J\].Clin Rehabil,2006,20（12）:1100- 1104．\[3\] Santini M, Ricci RP, Lunati M, et al.Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes\[J\].J Interv Card Electrophysiol,2009,24（1）:53-61.\[4\] 孙筱璐，关键，王莉，等.远程实时心电监测仪与常规心电图在心血管疾病中的监测和对比分析\[J\].中华心律失常学杂志，2010,14(4):274-278.\[5\] Engel H,Huang JJ,Tsao CK, et al. Remote realtime monitoring of free flaps via smartphone photography and 3G wireless internet: a prospective study evidencing diagnostic accuracy\[J\].Microsurgery, 2011,31(8):589-595.\[6\] Senatore G, Stabile G, Bertaglia E, et al. Role of transtelephonic electrocardiographic monitoring in detection shortterm arrhythmia recurrences after radiofrequency ablation in patients with atrial fibrillation\[J\].J Am Coll Cardiol,2005,45(6):873-876.\[7\] Vassilikos VP,Vogas V,Giannakoulas G, et al. The use of transtelephonic loop recorders for the assessment of symptoms and arrhythmia recurrence after radiofrequency catheter ablation\[J\]. Telemed J E Health,2010 ,16(7):792-798. \[8\] 夏云龙，王尹曼，田晓晨，等.心房颤动射频消融术后远程心电监测随访的意义\[J\].中华心律失常杂志,2011,15(4):264-267.\[9\] Mischke K, Zarse M, Perkuhn M, et al. Telephonic transmission of 12 lead electrocardiograms during acute myocardial infarction\[J\].J Telemed Telecare,2005,11(4):185- 190.\[10\] Jepsen HH, Egstrup K. Direct referral of patients with STelevation acute myocardial infarction to primary percutaneous coronary intervention. Prehospital use of telemedicine and risk stratification\[J\].Ugeskr Laeger,2007,169(47):4043-4047.
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