ABSTRACT
The electrocardiogram (ECG) is a key investigation in patients with palpitation, and may also be useful in patients with dizziness or syncope. One of the limitations of the 12-lead ECG is that, in patients with a history of intermittent symptoms, the ECG is often entirely normal between episodes. The 24-h ambulatory ECG recording is one of the most frequently requested investigations in the assessment of patients with a suspected intermittent arrhythmia. One of the main drawbacks of the 24-h ambulatory ECG recorder is its short duration. Although recordings can take place over 48 h or even longer, the recording is usually only of value if the patient happens to experience an episode of palpitation, dizziness or syncope while wearing it. Patients with intermittent symptoms are often reassured if their 24-h ECG recording was normal. However, such reassurance cannot be given if the patient was asymptomatic during the recording.
