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Long-Term ECG (Holter) Monitoring and Head-Up Tilt Test

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Cardiac Arrhythmias

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Abstract

Long term electrocardiogram monitoring is a very useful investigation to diagnose, assess prognosis and assess response to drug therapy in cardiac arrhythmic and ischemic disorders. Commonly it is used for the diagnosis of undiagnosed palpitation or syncope. Holter monitoring is used over one or two days where as event recorder and external loop recorder can be used for several days to weeks. Implantable loop recorder has the highest diagnostic value and can be used for several years to pick up very rare episodes.

Head up tilt test is commonly performed to diagnose vasovagal syncope in clinically indicated cases of undiagnosed syncope. To increase diagnostic yield and reduce procedure time, various pharmacological provocations have been introduced. The commonest positive response is type-1, where the syncope is associated with a fall in blood pressure and heart rate but not leading to asystole for more than 3 seconds. The risk of procedure is low, but in rare instances there can be prolonged period of asystole requiring cardiac resuscitation.

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Author information

Authors and Affiliations

  1. Cardiac Electrophysiology and Pacing, Asian Heart Institute and Research Center, Mumbai, MH, 400051, India

    Santosh Kumar Dora MD, DM

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  1. Santosh Kumar Dora MD, DM
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Correspondence to Santosh Kumar Dora MD, DM .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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© 2014 Springer-Verlag London

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Dora, S.K. (2014). Long-Term ECG (Holter) Monitoring and Head-Up Tilt Test. In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_12

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  • DOI: https://doi.org/10.1007/978-1-4471-5316-0_12

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5315-3

  • Online ISBN: 978-1-4471-5316-0

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