Female gender was significantly associated with higher average heart rates and more premature atrial beats, whereas male gender was associated with sinus bradycardia on 24-hour Holter monitoring.
Observational (n=310)
No
Does 24-hour Holter monitoring reveal gender-specific patterns in cardiac rhythm and conduction abnormalities in outpatient cardiology patients?
Twenty-four-hour Holter monitoring reveals distinct gender-specific arrhythmic patterns, with females exhibiting higher heart rates and more premature atrial beats, and males showing more sinus bradycardia and pauses.
p-value: p=<0.001
Abstract Introduction Twenty-four–hour ECG Holter monitoring provides a comprehensive assessment of cardiac rhythm, enabling precise quantification of arrhythmic burden and reliable detection of rhythm disturbances. Objective The primary objective of this study was to evaluate and characterize the results of 24-hour ECG-Holter recordings in patients attending the Specialized Outpatient Service of the Cardiology Clinic, a tertiary-level institution. Special emphasis was placed on exploring potential associations between Holter findings and patient gender. Methodology A retrospective observational study was conducted from October 2024 to October 2025, including all individuals who underwent 24-hour Holter monitoring at our tertiary center. Results A total of 310 patients were analyzed. The mean age was 55.6 ± 17.8 years, with a nearly identical distribution between females (50.6%) and males (49.4%). The mean heart rate was 72.8 ± 12.6 beats per minute (bpm), with a peak value of 124.9 ± 25.3 bpm and a minimum of 47.8 ± 13.7 bpm. Almost all patients (97.7%) exhibited some form of rhythm or conduction abnormality. The most frequent findings were premature ventricular beats (PVBs) and premature atrial beats (PABs), each averaging more than 1300 episodes per patient. On average, each patient exhibited 2.05 ± 0.82 arrhythmia types. Only 2.2% demonstrated changes suggestive of chronic ischemia, possibly reflecting the predominant clinical focus on rhythm interpretation. Pauses occurred in 15.8% of patients, lasting approximately 2.4 seconds on average, while sinus bradycardia appeared in 9.35%. Atrioventricular block was present in 5.2% and bundle branch blocks were observed in about 5% of cases. Regarding gender, as seen in table 1 male patients showed a significant correlation with the presence of pauses longer than 2.5 seconds, pause duration, atrial fibrillation, sinus bradycardia, ventricular tachycardia, and overall arrhythmia burden. In contrast, female patients correlated significantly with higher average, maximum, and minimum heart rates, the presence of PABs, and sinus tachycardia. The parameters with statistical significance were included in the regression model. The linear regression model with gender as the dependent variable (F=1, M=2) was statistically significant (F=3.948; p0.001), though it explained a modest portion of the variance (R²=0.127; Adjusted R²=0.095). Table 2 shows that average heart rate and PABs were significantly higher in females, while sinus bradycardia was more common in males. Conclusion Twenty-four–hour ECG Holter monitoring effectively detects arrhythmias, with PVBs and PABs being most common. Linear regression showed that gender differences were mainly reflected in average heart rate, sinus bradycardia, and PABs, with females having higher heart rates and more PABs, and males more often showing sinus bradycardia. These results highlight the value of Holter monitoring and gender-specific patterns in clinical evaluation.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Bakalli et al. (Mon,) conducted a observational in Cardiac rhythm and conduction abnormalities (n=310). Female gender vs. Male gender was evaluated on Association between Holter findings (heart rate, arrhythmias) and patient gender (p=<0.001). Female gender was significantly associated with higher average heart rates and more premature atrial beats, whereas male gender was associated with sinus bradycardia on 24-hour Holter monitoring.