Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting

Lap-kin Chiang; Lorna Ng

doi:doi:10.11648/j.jfmhc.20170301.13

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Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting

Lap-kin Chiang, Lorna Ng

Published in Journal of Family Medicine and Health Care (Volume 3, Issue 1)

Received: 13 December 2016 Accepted: 24 December 2016 Published: 18 January 2017

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Abstract

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.

Published in	Journal of Family Medicine and Health Care (Volume 3, Issue 1)
DOI	10.11648/j.jfmhc.20170301.13
Page(s)	12-16
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Electrocardiography, Holter Monitoring, Palpitation, Primary Care

References

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[3]	Wexler RK, Pleister A, Raman S. Outpatient approach to palpitation. Am Fam Physician. 2011:84 (1): 63-9.
[4]	ACC/AHA Guidelines for Ambulatory Electrocardiography: Executive Summary and Recommendations: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 1999;100: 886-93.
[5]	java applets for power and sample size. http://www.divms.uiowa.edu/~rlenth/Power/.
[6]	Summerton N, Mann S, Rigby A, Petkar S and Dhawan J. New-onset palpitations in general practice: assessing the discriminant value of items within the clinical history. Family Practice. 2001;18: 383-92.
[7]	Sreekumar S, Dauda B, Neha S, Abdel S et al. Limited Clinical Utility of Holter Monitoring in Patients with Palpitation or Altered Consciousness: Analysis of 8973 Recordings in 7394 Patients. A. N. E. 2008;13 (1): 39-43.
[8]	Khamis RY, Dancy M. Palpitations. Medicine. 2008;37 (2): 100-5.
[9]	Fuster V, Ryden LE, Cannom DS et al. ACC/AHA/ESC 2006 guidelines for management of patients with atrial fibrillation-executive summary. J Am Coll Cardiol. 2006;48 (4): 854-906.
[10]	Arya A, Haghjoo M, Khosrawi A, Emkanjoo Z, Sadr-Ameli MA. Predictors of arrhythmic events during second day monitoring in patients with normal first day Holter recordings. Indian Heart J. 2005;57: 241-4.
[11]	Chu CKK, Lee EFT, Leung CS, Lit ACH. The use of ambulatory electrocardiography in the emergency medicine ward to assess patients with symptoms possibly related to cardiac arrhythmia: a sharing of experience in a local hospital. Hong Kong Journal of Emergency Medicine. 2010;Vol. 17 (4): 316-322.
[12]	Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med. 1996;100 (2): 138-48.
[13]	Lok NS, Lau CP. Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly. Int J Cardiol. 1996;54: 231-6.
[14]	DiMarco JP, Philbrick JT. Use of ambulatory electrocardiographic (Holter) monitoring. Ann Inter Med. 1990;113: 53-68.
[15]	Safe AF, Maxwell RT. Transtelephonic electrocardiographic monitoring for detection and treatment of cardiac arrhythmia. Postgrad Med J. 1990;66: 110-2.
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[17]	Scalvini S, Zanelli E, Martinelli G, Baratti D, Giordano A, Glisenti F. Cardiac event recording yields more diagnosis than 24-hour Holter monitoring in patients with palpitations. J Telemed Telecare. 2005;11 (supp 1): 14-6.
[18]	Seipel L. The clinical value of Holter ECG recording. Internist. 2004;45: 1035-41.
[19]	Mclellan A, Mohamed U. Ambulatory electrocardiographic monitoring. Australian Family Physician. 2011;40 (8): 596-8.

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APA Style

Lap-kin Chiang, Lorna Ng. (2017). Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting. Journal of Family Medicine and Health Care, 3(1), 12-16. https://doi.org/10.11648/j.jfmhc.20170301.13

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ACS Style

Lap-kin Chiang; Lorna Ng. Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting. J. Fam. Med. Health Care 2017, 3(1), 12-16. doi: 10.11648/j.jfmhc.20170301.13

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AMA Style

Lap-kin Chiang, Lorna Ng. Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting. J Fam Med Health Care. 2017;3(1):12-16. doi: 10.11648/j.jfmhc.20170301.13

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@article{10.11648/j.jfmhc.20170301.13,
  author = {Lap-kin Chiang and Lorna Ng},
  title = {Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting},
  journal = {Journal of Family Medicine and Health Care},
  volume = {3},
  number = {1},
  pages = {12-16},
  doi = {10.11648/j.jfmhc.20170301.13},
  url = {https://doi.org/10.11648/j.jfmhc.20170301.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfmhc.20170301.13},
  abstract = {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.},
 year = {2017}
}

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TY  - JOUR
T1  - Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting
AU  - Lap-kin Chiang
AU  - Lorna Ng
Y1  - 2017/01/18
PY  - 2017
N1  - https://doi.org/10.11648/j.jfmhc.20170301.13
DO  - 10.11648/j.jfmhc.20170301.13
T2  - Journal of Family Medicine and Health Care
JF  - Journal of Family Medicine and Health Care
JO  - Journal of Family Medicine and Health Care
SP  - 12
EP  - 16
PB  - Science Publishing Group
SN  - 2469-8342
UR  - https://doi.org/10.11648/j.jfmhc.20170301.13
AB  - 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.
VL  - 3
IS  - 1
ER  -

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Author Information

Lap-kin Chiang

Family Medicine and General Outpatient Department, Kwong Wah Hospital, Hong Kong Special Administrative Region, China
Lorna Ng

Family Medicine and General Outpatient Department, Kwong Wah Hospital, Hong Kong Special Administrative Region, China

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Plain Text BibTeX RIS

APA Style

Lap-kin Chiang, Lorna Ng. (2017). Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting. Journal of Family Medicine and Health Care, 3(1), 12-16. https://doi.org/10.11648/j.jfmhc.20170301.13

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ACS Style

Lap-kin Chiang; Lorna Ng. Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting. J. Fam. Med. Health Care 2017, 3(1), 12-16. doi: 10.11648/j.jfmhc.20170301.13

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AMA Style

Lap-kin Chiang, Lorna Ng. Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting. J Fam Med Health Care. 2017;3(1):12-16. doi: 10.11648/j.jfmhc.20170301.13

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@article{10.11648/j.jfmhc.20170301.13,
  author = {Lap-kin Chiang and Lorna Ng},
  title = {Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting},
  journal = {Journal of Family Medicine and Health Care},
  volume = {3},
  number = {1},
  pages = {12-16},
  doi = {10.11648/j.jfmhc.20170301.13},
  url = {https://doi.org/10.11648/j.jfmhc.20170301.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfmhc.20170301.13},
  abstract = {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.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Holter Monitoring (Ambulatory Electrocardiography) Defined Cardiac Arrhythmia Among Patients Presented with Palpitation in the Primary Care Setting
AU  - Lap-kin Chiang
AU  - Lorna Ng
Y1  - 2017/01/18
PY  - 2017
N1  - https://doi.org/10.11648/j.jfmhc.20170301.13
DO  - 10.11648/j.jfmhc.20170301.13
T2  - Journal of Family Medicine and Health Care
JF  - Journal of Family Medicine and Health Care
JO  - Journal of Family Medicine and Health Care
SP  - 12
EP  - 16
PB  - Science Publishing Group
SN  - 2469-8342
UR  - https://doi.org/10.11648/j.jfmhc.20170301.13
AB  - 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.
VL  - 3
IS  - 1
ER  -

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