TITLE:
Prospective Study of Holter Monitoring in Pediatric Patients at Sohag University Hospital
AUTHORS:
Safaa Ali, Feby Sobhy, Mohamed Abd El Aal, Shiamaa Mahamoud
KEYWORDS:
Holter, Pediatric, Arrhythmia, ECG
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.7,
July
27,
2020
ABSTRACT: Background: To estimate the various
indications, values and misuses of Holter monitoring in the diagnosis and
management of pediatric patients. Methods: The study was a prospective
observational study, carried out at Pediatric Arrhythmia Clinic and at PICU of
Sohag University Hospital over two years from 09/2017 to 09/2019. It
encountered 80 pediatric patients (34 females), their age ranged from
29 days to 15 years with mean age of 6.18 years. All patients were subjected to
echocardiography, 12 leads ECG and holter monitoring for 24 hours. Minimum, mean, maximum
heart rate, rhythms and corrected QT were evaluated. Indications of Holter
examination, its abnormalities were analyzed, also its positive
diagnosis and management were defined. Results: Palpitations and syncopy
were the main indications for holter examination 22 (27.50%) patients for each, abnormal examination
in 17 (21.25%), chest pain in 13 patients (16.25%) and
cardiomyopathy (7.5%) (one with Hypertrophic Cardiomyopathy and five with
Dilated Cardiomyopathy). There were 50 (62.50%) patients had abnormalities in
Holter recordings. The highest contribution to diagnosis was in cardiomyopathy
(83.3%) where the most common abnormalities were ventricular
tachycardia (50%) and ventricular premature beats in (33.3%). An abnormal ECG
was significantly associated with a higher diagnostic yield (p = 0.0001). Conclusion: The most important indications for Holter monitoring
include palpitations, syncope, abnormal physical exam findings, chest pain, and
cardiomyopathy. Holter monitoring is an extremely important tool in the assessment
of patients with dilated cardiomyopathy. HM detects serious arrhythmias to
identify patients who are at increased risk for subsequent morbid events. The
abnormal ECG findings were associated with having an abnormal Holter, therefore
Holter monitoring can be used to help select which patients should get this
screening tool especially in low budget programs countries.