Sixty unselected patients with transient neurological symptoms underwent 24-hour ambulatory electrocardiographic (ECG) monitoring. Haemodynamically significant arrhythmias were observed in 32% of patients, but in only 3% of an age- and sex-matched control group. Nine patients received specific anti-arrhythmic therapy, which resulted in marked symptomatic improvement in each case. It is argued that 24-hour ECG monitoring is a valuable diagnostic tool in the investigation of transient neurological symptoms.
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