The value of Holter monitoring in the assessment of pediatric patients

Hegazy, Ranya A. and Lotfy, Wael N. (2007) The value of Holter monitoring in the assessment of pediatric patients. Indian Pacing and Electrophysiology Journal, 7 (4). pp. 204-214. ISSN 0972-6292

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Abstract

Aims: Holter monitoring (HM) has been established as one of the most effective noninvasive clinical tools in the diagnosis, assessment and risk stratification of cardiac patients. However, studies in the pediatric age group are limited. The present work aims at determining the value of HM in the diagnosis and management of children. Settings and Design: Retrospective study conducted at a tertiary referral arrhythmolology service. Methods and Material: Holter records of 1319 pediatric patients (54.1% males and 45.9% females) were reviewed. Their average age was 6.7± 4.1 years (5 days-16 years). Indications for which Holter monitoring was done were analysed as well as all the abnormalities diagnosed and factors that may increase Holter yield. Statistical analysis used: Statistical Package of social science (SPSS) version 9,0 was used for analysis of data. Results: The most common indications were palpitations (19.8%), syncope (17.8%), cardiomyopathy (12.6%), chest pain (10%), evaluation of antiarrhythmic therapy (6.8%), postoperative assessment (2.6%) and complete AV Block (2.4%). A sum of 141 Holter recordings were found abnormal with a total diagnostic yield of 10.7%. The highest contribution to diagnosis was in postoperative assessment (32.4%) and in cardiomyopathy (19.9%) where the most common abnormalities were frequent supraventricular / ventricular premature beats, supraventricular tachycardia, ventricular tachycardia and AV block. Diagnostic yield was low in patients with palpitations (5.7%) and syncope (0.4%). An abnormal ECG was significantly associated with a higher diagnostic yield (p=0.0001). None of the children with chest pain had abnormal Holter recordings. Conclusions: HM has an extremely valuable role in the assessment of high risk patients (postoperative and cardiomyopathy). However in children with palpitations, syncope and chest pain HM has a low yield. In this group of patients an abnormal ECG is more likely to be associated with abnormal Holter recordings.

EPrint Type:Article
Uncontrolled Keywords:Holter, Pediatric Patients, Arrhythmias, Cardiac Patients, Diagnosis, Management, Cardiomyopathy, Syncope, Palpatations
Subjects:Persons > Age Groups > Child
Cardiovascular Diseases > Heart Diseases > Arrhythmia > Atrial Fibrillation
Health Occupations > Medicine > Specialties, Surgical > Surgery
Surgical Procedures, Operative > Postoperative Care
Diagnosis > Diagnostic Techniques and Procedures > Diagnostic Techniques, Cardiovascular > Heart Function Tests > Electrocardiography
-Journal Repositories > Indian Pacing and Electrophysiology Journal
Persons > Age Groups > Infant
Cardiovascular Diseases > Heart Diseases > Arrhythmia
Nervous System Diseases > Neurologic Manifestations > Neurobehavioral Manifestations > Consciousness Disorders > Unconsciousness > Syncope
Pathological Conditions, Signs and Symptoms > Pathologic Processes > Arrhythmia
Cardiovascular Diseases > Heart Diseases
ID Code:2711
Deposited By:Indian Pacing and Electrophysiology Journal
Deposited On:10 March 2008

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