Utility of an automatic and patient-triggered cardiac event recorder: experience in children.

Abstract

Objective: This study aimed to evaluate the diagnostic yield of an event recorder capable of automatic and manual recording in children with possible arrhythmia related symptoms.

Methods: We evaluated retrospectively 81 children monitored with Novacor event recorder system between September 2021 and September 2024. All of the patients performed 12-lead electrocardiogram (ECG), 24-hour-Holter monitoring, and echocardiography before the cardiac event recording.

Results: Indications for cardiac event recorder monitoring were palpitations in 59 (72.8%) patients, chest pain and palpitations in 19 (23.5%) patients, and palpitations and presyncope in 3 (3.7%) patients. After a mean monitoring period of 14.40 ± 7.79 days, 65 (80%) children described symptoms and 41(63%) children had automatically or manually recorded arrhythmias. 63% of these arrhythmias were correlated with the symptoms. Of the 16 (19,8%) patients who were asymptomatic during the enrollment period, 9 (56%) had arrhythmia recorded with automatic arrhythmia detection property only. A total of 107 arrhythmias episodes were registered; forty-six (43%) episodes were patient triggered, and 61 (57%) were automatically recorded. While 24-hour-Holter monitoring detected a clinical diagnosis in 13 patients (16.7%), event recorder diagnosed clinical arrhythmia in 41 children (63%). Based on the event recorder and findings, 10 (12,3%) patients received an electrophysiology study/ablation.

Conclusion: We found that the automatic mode of the device provided additional clinical and therapeutic consequences. For this reason, a cardiac event recorder capable of automatically and manually recording may be a more preferable method in children with potentially arrhythmia related symptoms. Studies with larger patient series may provide illuminating data in this area.