Heart rate variability and arrhythmic patterns of 24-hour Holter electrocardiography among Nigerians with cardiovascular diseases

Abstract

BackgroundFacilities for Holter electrocardiography (ECG) monitoring in many Nigerian hospitals are limited. There are few published works in Nigeria on the use of 24-hour Holter ECG in cardiac arrhythmic evaluation of patients with cardiovascular diseases.ObjectiveTo study the clinical indications, arrhythmic pattern, and heart rate variability (HRV) among subjects referred for 24-hour Holter ECG at our Cardiac Care Unit.MethodsThree-hundred and ten patients (134 males and 176 females) were studied consecutively over a 48-month period using Schiller type (MT-101) Holter ECG machine.ResultsOut of the 310 patients reviewed, 134 were males (43.2%) and 176 were females (56.8%). The commonest indication for Holter ECG was palpitation followed by syncope in 71 (23%) and 49 (15.8%) of subjects, respectively. Premature ventricular complex and premature atrial complex were the commonest types of arrhythmia in 51.5% and 15% subjects, respectively. Ventricular arrhythmia was more prevalent in dilated cardiomyopathy patients (85.7%). The HRV of subjects with palpitation, stroke, and diabetes mellitus with autonomic neuropathy, using standard deviation of normal to normal intervals average (milliseconds), were 107.32±49.61, 79.15±49.15, and 66.50±15.54, respectively. The HRV, using standard deviation of averages of normal to normal intervals average (milliseconds), of patients with palpitation, stroke, and diabetes mellitus with autonomic neuropathy were 77.39±62.34, 57.82±37.05, and 55.50±12.71, respectively.ConclusionPalpitation and syncope were the commonest indications for Holter ECG among our subjects. The commonest arrhythmic patterns were premature ventricular complex and premature atrial complex, with ventricular arrhythmia being more prevalent in dilated cardiomyopathy. There was a reduction in HRV in patients with stroke and diabetic autonomic neuropathy.

Pattern of Arrhythmia among Hypertensive Patients in South-South, Nigeria: A 24-H Ambulatory ECG (Holter ECG) Study

“…Palpitation as an indication was similarly observed to predominate as an indication in ACC/AHA study [2,12]. We observed a higher incidence of conduction abnormalities in females than in males, which is similar to that reported by previous studies [1,13]. However, our study differs from another study that reported higher frequency of conduction abnormalities in males [2].…”

“…Cardiac arrhythmias entail abnormalities in the rate, rhythm, and conduction of cardiac impulses [1]. Irregularities in cardiac rhythm are frequently, though not always, indicative of cardiac disease.…”

Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

“…This is in agreement with the findings of other researchers. 47 , 48 The thinking is that a higher variability in the heart rate in response to various hemodynamic changes is indicative of a healthy autonomic nervous system. 48 However, a reduced HRV is suggestive of autonomic disequilibrium and increased vulnerability to life-threatening arrhythmias among patients with HF.…”

Autonomic Response in Subjects with Spinal Cord Injury: Brief Comments

“…18,19 and independent prognostic information about ventricular arrhythmia. 16 In relation spinal cord injury, subjects with chronic complete cervical SCI showed significant decrease of SDNN when compared to incomplete cervical SCI. 20,21 However, during acute phase of the incomplete cervical SCI was observed rise of SDNN possibly to recovery of autonomic function and remodeling of damaged axons after trauma.…”

“…14,15 Impairment of the autonomic cardiac regulation has been associated to increased incidence of cardiac arrhythmias and the analysis of heart rate variability (HRV) has been used as a tool for noninvasive assessment of cardiac autonomic balance in physiological and pathological conditions. 16,17,18 HRV analysis may provide a noninvasive method for estimating the sympatho-vagal balance. 18,19 and independent prognostic information about ventricular arrhythmia.…”