[Holter electrocardiography en pediatric cardiology: preliminary experience]

Evaluation of the diagnostic value of continuous electrocardiographic recording (Holter monitoring) in Paediatric Cardiology.

Retrospective study based on the data records of the Arrhythmia Department regarding patients with less than 20 years of age with Holter monitoring performed between January 1983 and February 1995 (374 recordings).

277 patients were studied, 163 were male and 114 female with a mean age of 12 +/- 5 years. Heart organic anomalies were present in 155 patients and 92 patients had previous cardiac surgery with cardiopulmonary bypass. Clinical indications for Holter recording were the evaluation of symptoms related to arrhythmias (38%), documented dysrhythmia (23%), arrhythmia detected on physical examination (18%) and evaluation of risk in patients without symptoms of arrhythmia (17%).

Holter recordings were performed during 24 hours with two channels (modified V1 and V5).

Significant rhythm and conduction disturbances were found in 122 patients. These were ventricular premature complexes > or = 10/hour (27 patients), AV block (25 patients) and supraventricular premature complexes > or = 10/hour (22 patients). Holter recording revealed significant dysrhythmias in 52% of patients with previously documented dysrhythmia, in 43% of patients referred for assessment of risk without symptoms of arrhythmia, provided insight in 48% of requests due to arrhythmia detected on physical examination and 24% of requests for symptoms related to arrhythmias. In 13 patients the results of Holter recording led to therapeutic or diagnostic measures.

Holter recording showed an overall sensitivity of 44% in the detection of significant arrhythmias and led to therapeutic and additional diagnostic measures in 11% of these patients. Holter recording seems to provide important information in the evaluation of arrhythmias in the paediatric age group.