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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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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