Holter Monitor Rhythm Parameters in Healthy Infants, Children, and Adolescents: Defining Reference Limits With...

Area of Science:

• Pediatric Cardiology
• Clinical Electrophysiology
• Biostatistics

Background:

• Ambulatory electrocardiography (ECG) has been used for 50 years.
• Reference limits for pediatric rhythm parameters are not well-defined.
• This study aimed to establish these ranges using meta-analysis.

Purpose of the Study:

• To determine age-specific reference ranges for 24-hour Holter monitoring in healthy pediatric populations.
• To provide updated benchmarks for cardiac rhythm parameters in infants, children, and adolescents.
• To facilitate accurate interpretation of ambulatory ECG data in young individuals.

Main Methods:

• Meta-analysis of published studies from 1969 to May 2024.
• Included 45 studies with 3886 participants.
• Data analyzed according to Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines, grouped by age.

Main Results:

• Heart rates decreased with age.
• Prevalence of first-degree and Wenckebach atrioventricular block increased with age.
• Premature atrial and ventricular complexes were most common in adolescents.

Conclusions:

• Proposed age-related reference limits for Holter monitoring in healthy pediatric populations.
• These limits provide essential data for clinical interpretation.
• Supports accurate diagnosis and management of cardiac rhythm abnormalities in children.