Relationship between 24- hour Holter variables, chest discomfort and syncope: Does age matter?

Samir Kanti Saha, Anatoli Kiotsekoglou, Erling Englund, Jonas Appelberg


One hundred and forty four ambulatory, non-emergent human subjects from 20-88 years of age were investigated following
routine 24 hour Holter monitoring referred by primary and tertiary care centers primarily for evaluation of palpitations
and syncope. The patients were grouped into 3 different age categories: A) 20-59 years of age (16%), B) 60-69 years
of age (26.4%) and C) > 70 years of age (57.6%). Heart rate profile, RR intervals, symptoms, frequency of premature
supra ventricular and ventricular complexes were registered. The data show that though the occurrence and frequency
of premature atrial and ventricular contractions over a period of 24 hours did not differ between the groups, the younger
subjects documented more subjective discomforts during the Holter monitoring. Extra-systoles in excess of 1000 beats / 24
hour occured incessantly throughout the registration. Patients with syncope and those without did not differ as regards the
Holter variables. However, subjects with atrial fibrillation had acceptable rate control and had significantly lower incidence
of syncope than those with sinus rhythm. The findings suggest that in a county setting, Holter monitoring for evaluation of
syncope may not be the first hand mode of investigation in a non emergent setting. On the contrary, the modality appears
to be valuable for monitoring patients with atrial fibrillation. Even mild symptoms in the elderly population may warrant closer
clinical follow up to prevent cardiac events and/or syncope leading to serious physical injury.

Full Text:



Copyright (c) 2015 The Authors

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.