Evaluation of patients with palpitations

Article Abstract:

Most heart palpitations are benign and do not require extensive diagnostic testing. Palpitations are characterized by a rapid fluttering in the chest, pounding in the neck or the feeling that the heart has skipped a beat. They can be caused by panic attack, exercise, and change of body position. They may lead to dizziness or fainting if serious. All patients with palpitations should have a detailed physical exam including a 12-lead electrocardiogram. Patients with a history of heart disease may require a 24-hour Holter monitor or electrophysiologic testing. Beta blockers, calcium channel blockers and radio-frequency ablation are effective treatments.

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Fractal variability versus pathologic periodicity: complexity loss and stereotypy in disease

Article Abstract:

Healthy systems exhibit fractal properties such as organized variability and self-similarity or scale invariance. In a disease state, a highly periodic pathologic dynamic emerges along with the breakdown of long-range order and the concomitant loss of scale-free structure. Thus, many diseases and syndromes are better conceptualized as a part of dynamic reordering rather than as manifestations of a disordering process. This pathologic order may serve as a basis for clinical diagnosis and has potential role in disease detection and prognostic assessment.

Analysis, Physiology, Pathological, Pathological physiology, Order-disorder models

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Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations: a cost-effectiveness analysis

Article Abstract:

Continuous-loop cardiac event recording for the diagnosis of palpitations may be most cost-effective in the first two weeks of monitoring. Patient-activated monitors can be used to transmit heart rhythm tracings to a monitoring station when the patient experiences symptoms of a rapid or changed heart rate. Researchers evaluated continuous monitoring in 105 patients, and identified about one diagnostic heart rhythm for each patient in the first week of recording. Only 0.01 diagnostic rhythm per patient was identified in the third week of monitoring.

Evaluation, Economic aspects, Patient monitoring, Physiologic monitoring, Ambulatory electrocardiography

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