Incidence of cardiac arrhythmia by using 24-hour holter ECG monitoring for assessment of pediatric patients with possibly arrhythmia-related symptoms in Chiangrai Prachanukroh hospital

Abstract

Background : An arrhythmia is a problem with rate or rhythm of heartbeat that it effect the heart’s ability to pump blood insufficiently to other organs.Most arrhythmias are harmless, but some can be serious and even life-threatening.So it is important to know about type of arrhythmia and treatment.
Objective : To describe incidence of cardiac arrhythmiasin 24-hour holter ECG monitoring and to study diagnostic test of 12-lead ECG in pediatric patients with arrhythmia-related symptoms when using 24-hour holter as standard investigation.
Methods : Retrospective descriptive study
Result : The 24-hour holter was done in 182 patients.Abnormal holter 60.99%.Age group from birth to 15 years old and 6 months.Mean age was 87.10 months old (±57.43).Boy 48.90%.Themost common presentations were accidental finding 39.01%, palpitation 20.88%, chest pain 10.44% and syncope 9.34%.Type of the most arrhythmia in 24-hour holter were PAC 22.52% and PVC 25.27%.12-lead ECG was sensitivity 71%, specificity 56%, PPV 72% and NPV 54%.Management in those patients were observed 65.38%, antiarrhythmic drugs 14.29%, Radiofrequency ablation (RFA) 2.20%.
Conclusion : 24 hr holter is the gold standard to diagnose arrhythmia especially in patient with unclear history taking, physical examination and 12-lead ECG including to diagnose life threatening arrhythmia condition.It is help to follow up after treatment.However patients with abnormal 12-lead ECG is more likely to be associated with abnormal 24 hr holter.