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A woman with congenital pulmonary valve stenosis treated by balloon valvulotomy had been visiting the outpatient clinic for many years with complaints of palpitations. Several 24-h electrocardiogram (ECG) recordings and resting ECGs (Fig. 1a) showed frequent premature ventricular contractions and two regular wide-complex asymptomatic tachycardias of a maximum of eight beats with a maximal frequency of 120 beats/min. However, these findings could not be related to her complaints.
The patient was included in a novel mHealth telemonitoring program. While the patient was having palpitations, a single-lead ECG was recorded (Fig. 1b). On these additional recordings atrial fibrillation could be diagnosed with intermittent bundle branch block.
There is a broad aetiology of palpitations, and these often occur outside the window of 24-h Holter monitoring. This case is one of the first to illustrate that mHealth programs, including on-demand ECG monitoring, can be of great importance in the diagnosis of arrhythmias.
M.A.C. Koole, G.A. Somsen, I.I. Tulevski, M.M. Winter, B.J. Bouma and M.J. Schuuring declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
- At last, mobile health leading to a diagnosis in a young patient with congenital heart disease
M. A. C. Koole
G. A. Somsen
I. I. Tulevski
M. M. Winter
B. J. Bouma
M. J. Schuuring
- Bohn Stafleu van Loghum