DIAGNOSTIC EFFICACY OF A SINGLE LEAD AMBULATORY 14-DAY ECG MONITOR IN SYMPTOMATIC CHILDREN

ABSTRACT Background CardioSTAT® is a single lead ambulatory ECG monitor that has been validated for use in adult patients. Recording is made through 2 electrodes positioned in a lead I configuration and allows monitoring for 2, 7 or 14 days. We sought to investigate its efficacy in children with paroxysmal palpitations. Methods In Phase I, the quality of tracings was compared between simultaneous CardioSTAT® recordings and the D1 lead recordings of a standard 12-lead ECG machine in 23 children. Phase II was a prospective observational cohort study comparing arrhythmia detection between the CardioSTAT® and currently used devices (24-hour Holter monitor and the Cardiomemo loop recorder) in 52 children complaining of palpitations. Results In Phase I, all but three rhythm strips could be correctly identified. The pacing spikes on three strips were not adequately identified by the observers on the CardioSTAT® recording. In Phase II, symptomatic episodes were reported in 42%, 73% and 100% of subjects during Holter, Cardiomemo and CardioSTAT® monitoring, respectively. An abnormal rhythm was detected in 13%, 23% and 35% of subjects by Holter, Cardiomemo and CardioSTAT®, respectively. The underlying rhythm during symptomatic events was determined in 90% of cases with CardioSTAT® while it was determined in only 19% and 29% with Holter or Cardiomemo monitors, respectively. Conclusion CardioSTAT® provided good quality tracings and was superior to the 24-hour Holter monitor and the Cardiomemo loop recorder in determining the presence or absence of pathologic arrhythmia in the study cohort.