Publication: Clinical Correlation between Symptoms and Risk Factors with Cardiac Arrhythmias on 24-Hour Holter Monitoring
Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine, Tribhuvan University
Abstract
Abstract:
Introduction
Ambulatory ECG Holter monitoring is necessary for the diagnosis of intermittent arrhythmias. The study aimed to study the clinical profile of symptomatic patients and association between symptoms and risk factors with specific arrhythmia.
Methods
This was a prospective observational study conducted to study the clinical profile of symptomatic patients who presented with unexplained palpitation, dizziness, syncope, or unexplained neurological events and who underwent 24-hour Holter monitoring for suspected cardiac arrhythmias.
Results
Overall, 265 patients were enrolled, of which 127 (47.9%) were male and 138 (52.1%) were female. The mean age of the study population was 55.5 ± 16.7. The most common indication was palpitation (58.5%), followed by dizziness (20%), unexplained neurological events (10.2%), and syncope (9.1%). The most common finding was Ventrical premature contractions (VPCs) seen in 195 (73.6%), followed by Atrial premature contractions (APCs) in 176 (66.4%), Supravenricular tachycardias (SVTs) in 33 (12.5%), and ventricular arrhythmias in 7 (2.6%). Sinus bradycardia was seen in 6 (2.3%), while sinus pause was seen in 10 (3.8%) patients. SVTs significatntly presented with palpitation (p-0.008) while sinus pause and sinus bradycardia presented with syncope (p-<0.001). Sinus pause was exclusively associated with syncope in all 10 patients (100 %).
Conclusion
Increasing age, smoking, hypertension, and pre-existing cardiac disease were significantly associated with abnormal Holter reports. Syncope was the only symptom that was associated with a higher prevalence of clinically significant arrhythmias. Only supraventricular tachycardias, sinus bradycardia, and sinus pause were associated with specific symptoms.
Description
Hemant Shrestha
Department of Cardiology, Maharajgunj Medical Campus, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal
Author
Surendra Bahadur Chhetri
Department of Internal Medicine, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Bibhav Bashyal
District Hospital, Gulmi, Nepal
Author
Sudip Bastakoti
Department of Internal Medicine, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Ratna Mani Gajurel
Department of Cardiology, Maharajgunj Medical Campus, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal
Author
Keywords
24-hour Holter monitoring, Cardiac arrhythmias, palpitation, syncope