Clinical Indications and Arrhythmic Patterns of 24-h Holter Electrocardiography among Cardiovascular Disease Patients

Background: This study aimed to evaluate the clinical indications and arrhythmic patterns in cardiovascular disease patients who were referred for Holter electrocardiography (ECG) in Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: A retrospective cross-sectional study was held at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Patient's data, including Holter ECG, was obtained from the local Holter Registry between July 2019 and December 2019. Results: A total of 89 patients were included in this study. The mean age was 50.1 ± 16.0 years old, and 48 patients (53.9%) were females. The most common indication was palpitation (39.3%) followed by the history of arrhythmia (14.6%), shortness of breath (13.5%), and chest pain (12.4%). Ventricular ectopic (VE) and supraventricular ectopic (SVE) were the most common arrhythmia in 70.8% and 12.4% of subjects, respectively. About 20.2% of patients had frequent VE, and Lown's Grade 4 was the most prevalent VE accounting for 45.9% of patients among all VE events. A total of 5.6% of patients had episodes of atrial fibrillation. Frequent SVE was found in 4.5% of patients, whereas 5.6% had supraventricular tachycardia. About 3.4% of patients had abnormal atrioventricular conduction, and 4.5% had chronotropic incompetence. Conclusions: Palpitation of unknown etiology was the most common clinical indication for Holter ECG among our patients. The most prevalent arrhythmias were VEs and SVEs, with Lown's Grade 4 being the most prevalent VEs. Holter ECG in patients with that indication was reasonably high diagnostic yield in detecting arrhythmia.