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Prolonged ECG Monitoring for Syncope in ED Feasible Safe

Diagnostic accuracy of ECG monitoring fair, but sensitivity increases with >12 hours of monitoring

heartbeat ekg

WEDNESDAY, Jan. 22, 2020 (HealthDay News) -- Prolonged electrocardiographic (ECG) monitoring of patients presenting to the emergency department with syncope is a safe alternative to hospitalization, according to a study published in the January issue of Academic Emergency Medicine.

Monica Solbiati, M.D., Ph.D., from Università degli Studi di Milano in Italy, and colleagues assessed the diagnostic accuracy of ECG monitoring in the emergency department in 242 patients with syncope and non-low risk for adverse events. Adverse and arrhythmic events were evaluated at seven and 30 days.

The researchers found that 12 percent of patients had seven-day serious outcomes, with 10 additional patients having serious outcomes at 30 days. ECG monitoring for identification of seven-day adverse events had a sensitivity of 0.55, specificity of 0.93, and a diagnostic yield of 0.07. For >12-hour ECG monitoring, the sensitivity, specificity, and diagnostic yield in the identification of seven-day adverse events were 0.89, 0.78, and 0.18, respectively. Findings were similar for 30-day adverse events. The median ECG monitoring time was 6.5 hours, and ECG monitoring findings were positive in 31 patients.

"These results suggest that prolonged (>12 hours) monitoring is a safe alternative to hospital admission in the management of non-low-risk patients with syncope in the emergency department," the authors write.

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