Aman Rabbia, Qureshi Ahmad Usaid, Sadiq Masood
Children's Hospital, Lahore.
J Pak Med Assoc. 2017 Jul;67(7):975-979.
To determine the yield of 48-hour Holter monitoring in children with unexplained palpitations and the significance of associated symptoms.
This descriptive study was conducted at the Children's Hospital and Institute of Child Health, Lahore, Pakistan, from January 1 to December 31, 2015. All children above 5 years of age with history of intermittent palpitations and normal basic cardiovascular workup were enrolled. A 48-hour Holter study was performed using Motara Holter Monitoring System. Frequency of various symptoms and abnormal Holter findings were analysed. SPSS 21 was used for data analysis.
Of the 107 patients, 69(64.5%) were males and 38(34.5%) females. The median age was 10 years (interquartile range: 5-18 years). Most common concomitant symptoms with palpitation included syncope/pre-syncope in 35(32.7%) patients, chest pain 22(20.5%), shortness of breath 21(19.6%) and colour change/pallor 11(10.3%). Holter recording was positive in 40(37%) patients. Frequent premature ventricular contractions 12(11.2%) and atrial ectopic beats 9(8.4%) were the most common findings. Holter findings were significantly more common in patients with history of shortness of breath and colour change/pallor during palpitations (p=0.002).
Extended 24-hour Holter monitoring in children with palpitations was an inexpensive, non-invasive investigation with a reasonably high diagnostic yield in detecting arrhythmias.
确定48小时动态心电图监测对不明原因心悸儿童的诊断价值及相关症状的意义。
本描述性研究于2015年1月1日至12月31日在巴基斯坦拉合尔儿童医院及儿童健康研究所进行。纳入所有5岁以上有间歇性心悸病史且基础心血管检查正常的儿童。使用Motara动态心电图监测系统进行48小时动态心电图研究。分析各种症状的发生频率及动态心电图异常表现。采用SPSS 21进行数据分析。
107例患者中，男性69例（64.5%），女性38例（34.5%）。中位年龄为10岁（四分位间距：5 - 18岁）。心悸最常见的伴随症状包括晕厥/先兆晕厥35例（32.7%）、胸痛22例（20.5%）、气短21例（19.6%）及面色改变/苍白11例（10.3%）。40例（37%）患者动态心电图记录呈阳性。最常见的表现为频发室性早搏12例（11.2%）和房性早搏9例（8.4%）。心悸发作时有气短和面色改变/苍白病史的患者中，动态心电图异常表现明显更常见（p = 0.002）。
对有心悸症状的儿童进行延长至24小时的动态心电图监测是一种廉价、无创的检查方法，在检测心律失常方面具有较高的诊断价值。
