Yield of 48-hour holter monitoring in children with unexplained palpitations and significance of associated symptoms

Objective: to determine the yield of 48-hour holter monitoring in children with unexplained palpitations and the significance of associated symptoms. methods: 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. results: 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). conclusion: extended 24-hour holter monitoring in children with palpitations was an inexpensive,non-invasive investigation with a reasonably high diagnostic yield in detecting arrhythmias. © 2017,pakistan medical association. all rights reserved.