{"id":6256,"date":"2023-01-12T16:33:51","date_gmt":"2023-01-12T15:33:51","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/?post_type=raccomandazione-prof&#038;p=6256"},"modified":"2023-01-12T16:33:51","modified_gmt":"2023-01-12T15:33:51","slug":"do-not-systematically-request-an-ecg-holter-in-patients-with-sporadic-palpitation-if-structural-heart-disease-has-already-been-excluded","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/do-not-systematically-request-an-ecg-holter-in-patients-with-sporadic-palpitation-if-structural-heart-disease-has-already-been-excluded\/","title":{"rendered":"Do not systematically request an ECG-Holter in patients with sporadic palpitation if structural heart disease has already been excluded."},"content":{"rendered":"<p>The 24-hour dynamic ECG according to Holter represents a simple and non-invasive but time consuming diagnostic tool. In clinical practice we often see inappropriate prescriptions. Palpitations are the most common indication (up to 20% of prescriptions). Holter ECG is indicated in the following groups of patients with unexplained palpitations: 1) when the clinical history, physical examination and 12-lead ECG suggest the possibility of an arrhythmia; 2) when a structural cardiac pathology or a channelopathy has been diagnosed, in case of familiarity of sudden death; 3) when the patient needs reassurance and an explanation of her symptoms; 4) when it is necessary to document the symptom-arrhythmia correlation.<\/p>\n","protected":false},"featured_media":6106,"template":"","meta":{"_wpv_contains_gutenberg_views":[""],"_layouts_template":["modello-per-raccomandazioni-professionista"],"_wp_page_template":["default"],"_wpml_word_count":["{\"total\":303,\"to_translate\":{\"it\":303}}"],"_edit_lock":["1673537509:2"],"_edit_last":["2"],"_thumbnail_id":["6106"],"_yoast_wpseo_primary_eta":["96"],"_yoast_wpseo_primary_disciplina":["109"],"_yoast_wpseo_primary_tipologia":["134"],"wpcf-pacchetto":["ITACARE-P #1"],"wpcf-bibliografia":["1. Steinberg JS, Varma N, Cygankiewicz I, et al. 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring\/telemetry. Heart Rhythm 2017;14:e55-e96. \r\n2. Located ET. New directions for ambulatory monitoring following 2017 HRS-ISHNE expert consensus. J Electrocardiol 2017;50:828-32.\r\n3. Goldberger JJ, Cain ME, Hohnloser SH, et al. American Heart Association\/American College of Cardiology Foundation\/Heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. Circulation 2008;118:1497-518\r\n4. Russo V, carbone A, Rago A et al. Elettrocardiogramma dinamico secondo Holter: dalle indicazioni alla refertazione, una guida pratica al corretto utilizzo in cardiologia clinica. 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