Descriptive evaluation of holter recordings at a teaching hospital in central Nigeria

Abstract

Background: Holter monitoring is a cardiovascular test available in few centres in Nigeria. It is indicated when cardiac rhythm disorders are suspected and standard electrocardiogram is not helpful. A simple overview of this test could give an idea of what cardiovascular complications are common. We evaluated the indications and simple results of outcome of Holter monitoring in a teaching hospital.
Methods: This descriptive cross-sectional study evaluated the indications and findings of patients that had a 24 hour Holter recording at the Jos University Teaching Hospital over a four year period between January 2011 to December 2014, utilizing routinely collected hospital data.
Results: A total of 113 subject hah Holter monitoring over the study period. The population had an age range 4-90 years, consisting of consisting of 60 (53%) male and 7 (6%) children. The main indications for Holter monitoring were palpitation (28%) and hypertensive heart disease (26%). Common findings following evaluations were tachycardia 49.5% and bradycardia 17.9%. Wide QRS complex tachycardia was detected in 20.4%, ST segment depression in 47.8% and atrial fibrillation in 28.7%. Asystole was seen in 18% of subjects with a mean duration of 2.17secs, arrest was recorded in 26.7% of those with asystole. The longest duration was 7.58secs. Premature atrial ectopics were seen in 56.7%, premature ventricular ectopics in 44.6% and multiple ventricular ectopics in 32.9% of subjects.
Conclusions: Palpitation and hypertensive heart diseases were the two most common indications for Holter monitoring test. Tachycardia and premature atrial contractions were the most common rhythm abnormalities seen.

Keywords: Holter monitoring, ambulatory electrocardiographic recording, arrhythmia, Jos, Nigeria