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[Continuous electrocardiographic recording with the Holter method in children. Indications and results]
Insights
Continuous Holter monitoring is effective for diagnosing pediatric arrhythmias, identifying over 47% of rhythm disturbances in children. This method is crucial for symptomatic patients and those with congenital heart disease.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
Context:
- Limited studies exist on continuous electrocardiographic recordings using the Holter method in children.
- Assessed 296 24-hour Holter recordings in 160 pediatric patients (average age 10.5 years).
Purpose:
- To evaluate the utility and diagnostic yield of 24-hour ambulatory electrocardiographic (Holter) monitoring in pediatric patients investigated for cardiac arrhythmias.
Summary:
- 61% of patients exhibited arrhythmias, with atrioventricular block, sinus node dysfunction, supraventricular, and ventricular arrhythmias being most common.
- Holter monitoring diagnosed 47.6% of identified rhythm disturbances.
- The study included patients with and without organic heart disease, and both symptomatic and asymptomatic individuals.
Impact:
- Holter monitoring is particularly valuable for diagnosing arrhythmias in symptomatic children, those with arrhythmogenic cardiac lesions, and for surveillance in congenital heart disease.
- The technique aids in detecting and monitoring postoperative arrhythmias, pacemaker function, congenital atrioventricular block, and chronic childhood arrhythmias.
Abstract:
There are relatively few reported studies of continuous electrocardiographic recordings by the Holter method in children. We report our experience of 296 24-hour recordings in 160 patients (average age 10.5 years), investigated for suspected or known cardiac arrhythmias. One hundred and ten patients (68.75%) had no organic heart disease and 6 patients (3.75%) had acquired lesions. Eighty-three patients (52%) were symptomatic. Sixty-three patients (39%) had normal recordings; 97 patients (61%) had a total of 126 arrhythmias. There were 45 cases of atrioventricular block, 24 cases of sinus node dysfunction, 39 cases of supraventricular arrhythmias and 18 cases of ventricular arrhythmias. Overall, 47.6% of these rhythm disturbances were diagnosed by Holter monitoring. This technique was particularly valuable in the diagnosis of arrhythmias in symptomatic patients, patients with arrhythmogenic cardiac lesions and in the detection and surveillance of postoperative arrhythmias in congenital heart disease, of pacemakers, of congenital atrioventricular block and of the chronic arrhythmias of childhood.