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المؤلفون: Mauro Biffi, Beatrice Gardini, Giuseppe Boriani, Matteo Ziacchi, Cristian Martignani, Alessandro Corzani, Igor Diemberger
المساهمون: Diemberger, Igor, Gardini, Beatrice, Martignani, Cristian, Ziacchi, Matteo, Corzani, Alessandro, Biffi, Mauro, Boriani, Giuseppe
المصدر: Heart. 101:1272-1278
مصطلحات موضوعية: Pacemaker, Artificial, Cardiac pacing, Defibrillation, medicine.medical_treatment, Cardiac Pacing, Artificial, Cardiovascular Diseases, Defibrillators, Humans, Outcome Assessment (Health Care), Quality Improvement, Electrocardiography, Ambulatory, Cardiology and Cardiovascular Medicine, Diagnostic tools, Cardiovascular symptoms, Defibrillator, Cardiovascular Disease, Outcome Assessment, Health Care, medicine, Palpitations, Medical diagnosis, business.industry, medicine.disease, Pacemaker defibrillator, Medical emergency, medicine.symptom, business, Human, Holter ecg
الوصف: Nowadays several diagnostic tools are available to investigate cardiovascular symptoms like palpitations, dizziness and syncope: ECG Holter (or ambulatory ECG, AECG), external and implantable event/loop recorders. Despite this technological burden, many diagnoses are still missed. In the meantime, we are facing an increasing use of implantable devices for cardiac pacing/defibrillation (CIED), which have rapidly evolved from simple pacing/shock boxes to devices including several diagnostic features. However, these functions are not adequately exploited in current clinical practice and several redundant diagnostic tests, like AECG, are still prescribed to CIED carriers, leading to an increase of costs and a delay in final diagnosis. This review is aimed at identifying the current role of AECG in CIED carriers in view of this technological improvement. First, we will briefly present the indications for AECG according to current guidelines. We will then provide a direct comparison of the different diagnostic features provided by AECG (and event/loop recorders) versus automatic diagnostic CIED to highlight the respective pros and cons. This will serve to carefully discuss these indications in view of the results of recent studies on CIED carriers, highlighting the need for proper implantation and follow-up. Eventually, we will provide useful hints to properly analyse AECG in CIED carriers, considering the different behaviours according to the implemented algorithms. We will conclude by suggesting updated indications for AECG.
وصف الملف: STAMPA
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المؤلفون: Mauro Biffi, Rajendra Shrivastav, Maneesh Shrivastav, Jitendra Makkar
المصدر: Heart Asia. 5:112-119
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Incidence (epidemiology), Cardiac arrhythmia, Disease, medicine.disease, Review in Cardiovascular Technology, Health care, Ambulatory, medicine, Medical emergency, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, Socioeconomic status, Selection (genetic algorithm), Reimbursement
الوصف: Cardiovascular disease (CVD) in India comprises the bulk of non-communicable diseases, resulting in 2 million deaths per year. The incidence of CVD in India is estimated to be up to four times higher than in other countries. Though the quantification of the prevalence of rhythm disorders in India is not available, it can be inferred to be proportionately high. Identification and treatment of arrhythmia is limited by several socioeconomic factors including low health insurance penetration, limited reimbursement and high out-of-pocket expenditures. Thus, there exists a need in India to (1) select an appropriate tool that is both high yielding and cost effective and (2) employ a suitable patient selection method. This paper focuses on these two aspects for cardiac arrhythmia diagnosis using ambulatory monitoring technology, while keeping in mind the dynamics of the Indian healthcare setting.