HUMAN VALIDATION IN HOLTER MONITORING: THE ROLE OF SPECIALIZED TECHNICAL ANALYSIS IN THE ERA OF ARTIFICIAL INTELLIGENCE AND TELECARDIOLOGY

Vollständiger Abstract

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Ambulatory electrocardiographic monitoring has undergone a profound technological transformation. Contemporary Holter systems can acquire long recordings, automatically detect candidate arrhythmias, quantify heart-rate behavior, classify ectopic beats, identify pauses, and transmit examinations through digital platforms. Artificial intelligence further increases the scale and sophistication of automated electrocardiographic analysis. These developments, however, do not eliminate the practical problem of validation. Electrocardiographic recordings remain vulnerable to motion artifact, electrode instability, signal loss, noise, morphology variation, and classification errors. This manuscript examines specialized human technical review as a quality-control layer positioned between automated processing and definitive physician interpretation. It expands a practice-based model in which recording quality is first assessed; automated findings are then reviewed; rhythm, heart-rate behavior, ectopic activity, pauses, conduction abnormalities, atrial arrhythmias, and symptom-event relationships are organized; and a structured technical pre-analysis is prepared for medical interpretation. The article also discusses telecardiology, remote workflows, artificial intelligence, data governance, quality assurance, and future models of human-machine collaboration. The manuscript is a narrative and practice-based review and does not report a prospective clinical trial or claim independent diagnostic authority for the technical analyst. Its central proposition is that automation provides scale, specialized technical review provides verification and organization, and the physician retains responsibility for clinical interpretation, diagnosis, and therapeutic decision-making.