Initial experience with novel mobile cardiac outpatient telemetry for children and adolescents with suspected arrhythmia.

OBJECTIVES: To report use of a novel mobile cardiac outpatient telemetry (MCOT) system for evaluation of children and adolescents with suspected cardiac arrhythmia.

DESIGN: Prospective data collection and retrospective analysis.

SETTING: All patients who received MCOT from The Children's Hospital at the Cleveland Clinic between 1/14/04 and 2/12/05 were screened. Patients older than 21 years and those with previously documented arrhythmia were excluded.

PATIENTS: Fifty-nine consecutive MCOT studies were performed. Five patients met exclusion criteria leaving 54 subjects (mean age 12.4+/-4.5 years; range 3.2-19.7 years; 46% male) for inclusion.

INTERVENTIONS: The MCOT system (CardioNet, USA) consists of a 3-electrode, 2-channel sensor that transmits wirelessly to a portable monitor. Monitors continuously store, analyze, and transmit the electrocardiogram through cellular and land telephone networks to a central station. MCOT was performed for 9-32 consecutive days (mean 24.5+/-7.4). Results. Twenty-one subjects (39%) did not experience symptoms during MCOT, yielding a diagnostic rate of 61% (N = 33). Of the 33 diagnostic studies, 9% (N = 3; mean age 16.9+/-0.6 years; range 16.2-17.3 years; 1 male) showed supraventricular tachycardia and 9% (N = 3; mean age 11.1+/-2.7 years; range 8.2-13.5 years; 1 male) showed supraventricular or ventricular ectopy. Minor skin irritation at sites of electrode placement was the only complication of MCOT (N = 5).

CONCLUSIONS: MCOT is safe and useful for evaluation of children and adolescents with suspected arrhythmia, providing a diagnosis in 61% of subjects. The diagnostic yield of MCOT was superior to that expected from traditional event and Holter monitors in this pediatric population.