[Statistical study of the profitability of recording cardiac electric activity by Holter's technic in diagnostic practice. Apropos of 200 cases]. / Etude statistique de la rentabilité de l'enregistrement de l'activité électrique cardiaque, par la technique de Holter, en pratique diagnostique. A propos de 200 cas.

The ambulant recording of the electrocardiogram by the Holter technique has become one of the non invasive examinations widely used in two indications: paroxysmal arrhythmias and coronary disease. However, the technical limitations of the method and the occasionally improper extension of the indications of Holter recording lead to disappointing results. The aim of this work is an estimation of the usefulness of Holter as a function of the desired information by a statistical study. Of 646 consecutive recordings, 200 were taken at random; 169 usable ones were classed in 7 categories according to the clinical requirement; the overall usefulness amounts to 27.5 percent of the cases in which Holter permits a diagnosis. As far as paroxysmal disturbances of rhythm are concerned, Holter is more efficacious than the standard electrocardiogram. However, the efficiency of the method is low: 17.4 percent of cases when it was required to find a cardiac arrhythmia causing a cerebral vascular accident, and even lower, 5.1 percent, when a malaise was concerned. In 20 percent of the cases was a useful tool in diagnosing thoracic pain. In 9.5 percent of the cases the tracings were not interpretable owing to their poor quality. These findings urge more rigor in the choice of indications and a better control of technical problems if the efficacy of the method is to be improved.