Abstract

Objective: In our study, we evaluated 24-hour rhythm holter monitarization (HM) indications in pediatric patients presenting with palpitations. The aim of this study was to determine the type and frequency of rhythm disorders seen in holter, and to emphasize the place of holter in diagnosis and treatment.

Material and Methods: 383 HM results of 364 patients in the age of 4 and 17 (average age 13.1 ± 3.4) who applied to the pediatric cardiology outpatient clinic with complaint of palpitation between January 2016 and January 2018 were evaluated retrospectively.

Results: In 11.5% of patients (n=42) dysrhythmia was detected in ECG, in 33% of them (n=120) dysrhythmia was detected in Holter. If we look at the Holter indications of the patients 88.5% had normal ECG examination, but ongoing unspecified of palpitations and dysrhythmic. 56.9% of patients (n=206) had complaint of isolated palpitation, 43.4% of patients (n=158) had other coexisting complaints such as chest pain (24.2%) and syncope (10.4%). In patients with dysrhythmias in both ECG and HM (36.1%), ECG was normal and the rate of severe dysrhythmia was found to be significantly higher in patients with arrhythmia (15.5%) than in patients with HM (p = 0.023). The most common rhythm disorders in holter results were 10.1% (n=37) SVE and 9% (n=33) VES. Coincidence of two rhythm disorders was 2.4% (n=9). If the rhythm disorders in HM were examined according to age groups, in the age ≤ 10; the frequency of SVE was %3, the frequency of VES was 1.4%. On the other hand in patients of age ≥11, the frequency of SVE was 7.1%, the frequency of VES was 7.7%. According to age group there was no statistically significant difference in dysrhythmia distribution in ECG and HM (p>0.05). 

Conclusion: In this study, dysrhythmia was detected about one third of patients who applied to the pediatric cardiology outpatient clinic with the complaint of palpitation and serious dysrhythmia was detected in 7.1% of them (n=26). Abnormal ECG was found to increase the contribution of holter recording to the diagnosis. In addition, in patients with normal ECG, the recording of  ysrhythmia in the holter, ECG may be inadequate in detecting rhythm disorders and therefore, HM may be a useful diagnostic tool especially in pediatric age group. 

Keywords: Cardiac dysrhythmia, Children, Dysrhythmia, Holter monitoring, Palpitation

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Copyright © 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Karamanlı G, Kibar Gül AE, Azak E, Gürsu HA, Çetin İİ. Evaluation of the results of rhythm holter monitorization in childrenwith palpitation in childhood. Turk J Pediatr Dis [Internet]. 2020 Jun. 26 [cited 2025 Aug. 23];14(4):318-24. Available from: https://turkjpediatrdis.org/article/view/676