Experience with Holter monitoring for evaluation of infant arrhythmia

Anita Baghel, Manoj Kumar, J. P. Soni, Mudit Agarwal, Ravi Kumar


Background: Arrhythmia is defined as abnormal heart rates. Sometimes they are intermittent and difficult to diagnose on routine ECG. Neonatologist and Pediatrician needs to rapidly establish accurate diagnosis and management for infants suspected to have arrhythmia. Hence Holter monitoring of the infants presenting with symptoms suggestive of arrhythmia is necessary as it provides a continuous record of heart’s electrical activity. The aim of this paper is to find out the role of continuous ambulatory electrocardiographic monitoring in daily clinical practice of Pediatrics.

Methods: All infants including neonates, either inborn or brought to the paediatric emergency with risk factors, between January 2016 to January 2018, were included in this prospectively study. Evaluation including chest X-ray, standard 12-lead electrocardiography, 24 hours continuous ECG monitoring using Mortara holter, echocardiography, biochemical and haematological analysis.

Results: A total of 73 babies were enrolled in present study. In this study arrhythmia was found in 29 (39.72%) new-borns. The most common arrhythmia observed was supraventricular tachycardia (SVT) (41.3%). Other arrhythmia observed were ventricular tachycardia (VT), AV block (34.4%), atria premature beats (3.4%) and ventricular premature beats (6.89%), tachy-bradyarrhythmia (3.4%) and junctional rhythm (3.4%). Of 29 arrhythmia patients four were diagnosed solely by Holter monitoring. None of the babies had long QT syndrome on Holter monitoring.

Conclusions: Cardiac arrhythmias are important causes of infant morbidity, and mortality if undiagnosed and untreated. It is important for the neonatologist and paediatrician to be aware of these of arrhythmias and the various diagnostic modalities available for them. A Holter electrocardiogram may be of value in identification of these transient arrhythmic events.


Arrhythmia, Infant, Holter

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