Indications for and the diagnostic yield of 24-hour Holter monitoring: a prospective study at the Korle Bu Teaching Hospital
Background: Holter monitoring (HM) is an important tool used to evaluate symptoms suspected to be caused by arrhythmias. This study was aimed at determining the diagnostic yield of Holter monitoring among symptomatic and asymptomatic patients undergoing HM at the Korle-Bu Teaching Hospital.
Methods: This was a prospective study among 400 consecutive symptomatic and asymptomatic patients undergoing HM from August 2006 to December, 2009 at the Korle-Bu Teaching Hospital. Data from the Holter study were analyzed, and symptoms linked to arrhythmias were evaluated to determine the diagnostic yield of HM in symptomatic and asymptomatic patients.
Results: The mean age of the patients was 51.81 ± 16 years. The most common indications (symptoms) for HM were palpitation (62.9%) and dizziness (34.0%); about half (53.3%) of the symptomatic patients had only one indication. Among the symptomatic group, 28 in 115 symptoms were linked to arrhythmias giving a diagnostic yield of 24.3% whereas in the asymptomatic group 1 in 33 of symptom was linked to arrhythmia giving a diagnostic yield of 3.0%. The study found an overall diagnostic yield of 19.6%.
Conclusion: HM as a regular health check for the general population (asymptomatic cohorts) is not cost effective and does not provide significant data to influence care except when the subject is found to have symptoms.
Funding: Funded by the Authors
Keywords: arrhythmias, indications, Holter monitoring, diagnostic yield, Ghana