Key result
In pediatric patients, a standard deviation of normal-to-normal RR intervals (SDNN) of <163 ms on 24-hour Holter monitoring predicted vasovagal syncope with an AUC of 0.753.
Why the study?
To evaluate the diagnostic value of 24-hour Holter heart rate variability parameters in pediatric patients with vasovagal syncope and explore underlying autonomic mechanisms.
Do heart rate variability parameters from 24-hour Holter monitoring have diagnostic value in pediatric patients with vasovagal syncope?
Cross-Sectional (n=77)
No
Do heart rate variability parameters from 24-hour Holter monitoring have diagnostic value in pediatric patients with vasovagal syncope?
Effect estimate: AUC 0.753 (95% CI 0.642-0.864)
Absolute Event Rate: 139% vs 182%
p-value: p=<0.001
Time-domain heart rate variability parameters, particularly SDNN, obtained from 24-hour Holter monitoring may serve as a useful diagnostic tool in pediatric patients with vasovagal syncope.
May support pediatric VVS evaluation; leaves open prospective validation before diagnostic adoption.
Objective: This study evaluated the diagnostic value of heart rate variability (HRV) parameters obtained from 24-hour Holter monitoring in pediatric patients with vasovagal syncope (VVS) and compared them to a control group. The study also analyzed time-domain and frequency-domain HRV parameters to explore the autonomic mechanisms underlying VVS and the diagnostic potential of HRV. Methods: This retrospective study was conducted at *** Women’s and Children’s Health Training and Research Hospital. Forty-one children with VVS and 36 healthy controls undergoing 24-hour Holter monitoring for ventricular extrasystoles were included. Comprehensive cardiac, neurological, and demographic evaluations were performed for all participants. HRV parameters were analyzed from 24-hour Holter recordings, and group comparisons were performed using the Mann–Whitney U test. Spearman correlation and Receiver Operating Characteristic analyses were also conducted. Results: Time-domain HRV parameters were significantly lower in the syncope group compared to those in the control group (p < 0.05). No significant differences were observed in frequency-domain parameters. The standard deviation of normal-to-normal RR intervals (SDNN) demonstrated the highest diagnostic accuracy, with a cut-off value of
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Yükçü et al. (2025) conducted a cross-sectional in Vasovagal syncope (n=77). Vasovagal syncope vs. Healthy controls without syncope was evaluated on Standard deviation of normal-to-normal RR intervals (SDNN) (AUC 0.753, 95% CI 0.642-0.864, p=<0.001). In pediatric patients, a standard deviation of normal-to-normal RR intervals (SDNN) of <163 ms on 24-hour Holter monitoring predicted vasovagal syncope with an AUC of 0.753.
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