Occurrence of arrhythmias in general practice

Objective - To study the occurrence and distribution of arrhythmias in patients with symptoms possibly caused by arrhythmias, in order to support the diagnostic process in general practice. Design - From 1989-1991 all patients who consulted their general practitioner with symptoms or signs possibly indicating an arrhythmia had a transtelephonic electrocardiogram, which was sent to the Department of Cardiology for interpretation. Setting - 20 Dutch general practices, serving a population of nearly 50 000 inhabitants. Subjects - A total of 868 patients were included in the study. Results - An arrhythmia was documented by ECG in 32% of the patients. Of these, 31% clinically more relevant arrhythmias needed medical attention. An incidence of 2.6 arrhythmias per 1000 listed patients was calculated. There was a highly positive correlation between the occurrence of arrhythmias and age. Relatively more arrhythmias were seen in men, in patients with occasional findings, and when there were symptoms that possibly indicated haemodynamic imbalance. Conclusion - Clinically relevant arrhythmias can be detected in general practice with 12-lead ECG recording in a significant proportion of patients with symptoms and physical findings suggesting an arrhythmia. The distribution of arrhythmias described in this study can help general practitioners in their diagnostic management.