USEFULNESS OF 24 HOURS HOLTER MONITORING IN DIAGNOSING PAEDIATRIC ARRHYTHMIAS

Dr.G. Dharmaraj, Dr.G. Ravishankar

Abstract


Pediatric arrhythmias vary in presentation from congestive failure in infants to palpitations and syncope in older children. Our study aims to identify the place and role of continuous electrocardiographic 24 hr ECG monitoring in daily clinical practice of pediatric cardiology.

SUBJECTS AND METHODS:

We enrolled 100 pediatric patients (<12 years age) who were referred during the period of November 2018 to May 2019 to our centre. Among 100, 80 children referred for symptoms of arrhythmia and 20 children asymptomatic with ECG changes. All were evaluated initially with 12 lead electrocardiography (ECG) and trans-thoracic echocardiography. 24-hours holter monitoring was done for further evaluation.

RESULTS: 

Totally there were 100 patients. Out of 100, 55 were males (55%) and 45 were females (45%). Age group varied  from birth to 12 years.11% patients belong to < 2 years old, 32% patients were between 2 to 8yrs and remaining 57% patients were between 8 to 12 years of age group. Out of the 100 patients studied  80 patients who were symptomatic, 35 patients (43.75%) had benign arrhythmias, 10(12.5%) patients had frequent VPCs but none developed ventricular tachycardia, 8(10%) patients had frequent APCs,  3 (3.75%) patients had  2nddegree AV block  and 2(2.5%) patients had CHB and 2(2.5%) had intermittent preexcitation syndrome. Among 20 asymptomatic children 11 had complete heart block and 9 had WPW syndrome but none developed supraventricular tachycardia.

CONCLUSION:

Arrhythmias in pediatric population have varied presentation and diagnosis of pediatric arrhythmias remains challenging. 24 hours Holter monitoring is an important diagnostic tool in patients with suspected symptoms and it helps in risk stratifying pediatric patients for further management.

Keywords


Ventricular premature complex, Atrial premature complex, Complete heart block.

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