Prospective Study of Holter Monitoring in Pediatric Patients at Sohag University Hospital

摘要

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.