When to Admit the Patient with Palpitation
Diagnostic purposes Severe structural heart disease (e.g. severe valve disease, complex congenital heart disease, cardiomyopathy, severely impaired left ventricular systolic function (ejection fraction <35%)), suspected or ascertained Primary electrical heart disease (channelopathy), suspected or ascertained Family history of sudden death Need to perform electrophysiological study, invasive investigations or in-hospital telemetric monitoring Therapeutic purposes Bradyarrhythmias requiring implantation of pacemaker Cardiac device malfunction not rectifiable by reprogramming Ventricular tachyarrhythmias requiring immediate interruption and/or implantable cardoverter-defibrillator (ICD) implantation or catheter ablation Supraventricular tachycardias requiring interruption immediately or in a short time, or catheter ablation Presence of heart failure or other symptoms of haemodynamic compromise Severe structural heart diseases requiring surgery or interventional procedures Severe systemic causes (see Table 8.5) Severe psychotic decompensation |
Source: Raviele A, Giada F, Bergfeldt L, et al. (2011) Management of patients with palpitations: a position paper from the European Heart Rhythm Association. Europace 13, 920934. Reproduced with permission of Oxford University Press.