Holter monitoring detected significant cardiac arrhythmia in 39.1% of primary care patients presenting with palpitation, with smokers and those with ischemic heart disease at higher risk (P<0.05).
Cross-Sectional (n=279)
No
What is the prevalence and what are the predictors of significant cardiac arrhythmia detected by Holter monitoring in primary care patients presenting with palpitation?
Holter monitoring detects significant cardiac arrhythmias in nearly 40% of primary care patients presenting with palpitations, particularly among smokers and those with ischemic heart disease.
Palpitation is non-specific and represents one of the most common symptoms in general medical settings. Discerning cardiac from noncardiac causes is important. A 24-hour ambulatory electrocardiography (Holter) monitor is usually used. This is a retrospective cross-sectional review including all patients presented with palpitation and had Holter monitoring performed in a regional primary care clinic of Hong Kong during the year 2010 to 2014. Clinical information and Holter outcomes were retrieved and analyzed to examine Holter monitoring defined significant cardiac arrhythmia and assess the predictive patient characteristics associated with significant cardiac arrhythmia. Holter monitoring were arranged for 89 (31.9%) male and 190 (68.1%) female patients. 163 (58.4%) patients had associated chronic comorbidity, including 38.0% had hypertension. 109 (39.1%) Holter monitoring showed significant cardiac arrhythmia, including prolong QT interval (11.1%), frequent supraventricular/ventricular ectopics (9.0%) and supraventricular/ventricular ectopics in bigeminy or trigeminy (5.0%). Patients who were smokers, or with concomitant ischaemic heart disease were more likely to have significant cardiac arrhythmia (P < 0.05). 39.1% of Holter monitoring for patients presented with palpitation in the primary care setting have significant cardiac arrhythmia, which need referral to medical specialist for further management.
Lap-kin Chiang (Sun,) conducted a cross-sectional in Palpitation (n=279). Holter monitoring was evaluated on Significant cardiac arrhythmia. Holter monitoring detected significant cardiac arrhythmia in 39.1% of primary care patients presenting with palpitation, with smokers and those with ischemic heart disease at higher risk (P<0.05).