The Diagnostic Significance of the Holter Monitoring in the Evaluation of Palpitation at Tanta University Hospitals

Background: Palpitations are the second-most common cause of primary healthcare referrals to cardiologists and are linked to long-term morbidity. Despite the absence of a significant underlying cause, a considerable number of patients report fear and anxiety. The purpose of this study was to assess individuals who were evaluated for palpitation in order to ascertain the diagnostic yield of 24 or 48 hours of Holter monitoring.

Methods: 105 participants participated in this prospective observational cross-sectional research, children and adults, with palpitations, dizziness and syncope, with Holter monitoring 24 or 48 hours. Every patient had a thorough medical history, clinical evaluation, and physical assessment, Resting Electrocardiography (ECG), Transthoracic Echocardiography, and Holter monitoring. Patients were further subdivided into two groups: Positive Holter group and Negative Holter group.

Results: Symptoms among positive Holter response showed that 48.6% had palpitations, 34.2% had dizziness and 13.3% had syncope. Higher age, increased frequency of danger factors (Diabetes mellitus, Hypertension, Ischemic heart disease, cardiomyopathy), symptoms (Palpitations, Dizziness, Syncope), Premature ventricular contractions and lower Ejection fraction was observed in patients with positive Holter response compared to patients with negative Holter response. There was no significant association with sex, smoking, Atrial fibrillation, regular sinus rhythm, and premature atrial contractions (P ≤ 0.05).

Conclusions: Holter Monitoring retains its value, despite the appearance of new investigations and considered the first line for assessment of palpitations as it is widespread and not expensive. It has a good outcome if the patient’s symptoms are suggestive for arrhythmia, syncope and dizziness.