Ambulatory ECG recordings: a spectrum of technology.

A four-tiered approach to data reduction-observer analysis, semi-automated scanning, automated scanning, and computer applications-of ambulatory electrocardiographic recordings is now possible as a result of refinements in technology. Clinical circumstances, cost, and requirements of the involved institution or laboratory will dictate to what extent more advanced technology is needed. Although computer application will increase the detection sensitivity of ectopic beats, sophisticated, costly systems are still required for the analysis of high-frequency ectopic activity tapes.

Semiautomated data reduction of ventricular ectopic activity: methodology and clinical application.

A semiautomated ventricular premature beat (VPB) detector was developed which detects VPBs based upon a logical combination of prematurity, amplitude, and width. This system utilizes technicians to define sensitivity and criteria of VPB detection and to monitor the system's performance using a unique feedback system. Technician-assisted semiautomated scanning was found superior both to the system using preselected criteria and sensitivity of the detectors, and to traditional Holter scanning for the detection of single and repetitive VPBs.

Monitoring for serious arrhythmias and high risk of sudden death.

Ventricular premature beats (VPBs) are present in 85% of patients with coronary heart disease (CHD). A classification of VPBs based on frequency, multiformity, repetitive pattern, and degree of prematurity promises to aid in identifying patients at high risk of sudden death. Advanced grade or repetitive forms of VPBs are observed in 41% of patients with CHD who are monitored for 24 hours while ambulatory.