The clinical value of 24-hour dynamic electrocardiogram for syncope of unknown reason / 中国医师进修杂志

ABSTRACT

Objective To analyze the clinical value of 24 h dynamic electrocardiogram (Holter) for cardiogenic syncope caused by arrhythmia and myocardial ischemia.Methods A total of 134 patients from February 2010 to October 2012 diagnosed syncope who received Holter and coronary arteriography (CAG) or electrophysiological examination were enrolled in this study.The daily record and the time of syncope were recorded exactly.Results Seventy-eight patients had final diagnosis by CAG and electrophysiological examination,and 59 patients were diagnosed by Holter.The true positive was 42 cases,the true negative was 39 cases,the false positive was 17 cases and the false negative was 36 cases.Thus,the sensitivity,specificity,positive predictive value and negative predictive value were 53.85％ (42/78),69.64％ (39/56),71.19％ (42/59) and 52.00％(39/75).Conclusions Holter is a very important diagnostic method for cardiogenic syncope caused by arrhythmia and myocardial ischemia.Repeated and multiple examination can improve the diagnostic yield.