Document Detail

Comparison of detection of arrhythmias in patients with chronic heart failure secondary to non-ischemic versus ischemic cardiomyopathy by 1 versus 7-day holter monitoring.
MedLine Citation:
PMID:  20723645     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to compare the diagnostic sensitivity of 1-day Holter monitoring versus 7-day Holter monitoring (7DH) to detect atrial and ventricular arrhythmias in a population of stable patients with chronic heart failure and left ventricular dysfunction. Sixty-three consecutive stable patients with chronic heart failure with left ventricular ejection fractions < or =50% were included. Blood samples were obtained, the Minnesota Living With Heart Failure Questionnaire was administered, and echocardiography, 6-minute walk tests, and 7DH were performed at enrollment. The mean ejection fraction was 35.8 +/- 9.8%, and the mean age was 55.5 +/- 13.9 years. Seven-day Holter monitoring did not significantly increase the detection of nonsustained atrial tachycardia or atrial fibrillation. In contrast, the incidence of nonsustained ventricular tachycardia increased in nonischemic patients from 35.1% on day 1 to 54.1% on day 7 (p = 0.01). In ischemic patients, the sensitivity increased from 11.5% to 46.2% (p = 0.004). Two patients without nonsustained ventricular tachycardia on day 1 had episodes of 13 and 16 beats on days 3 and 6 of monitoring. In patients with left ventricular ejection fractions >35% and N-terminal-pro-brain natriuretic peptide levels <1,000 pg/ml, no episodes of nonsustained ventricular tachycardia were detected on day 1 in nonischemic and ischemic patients, but 7DH detected 3 new patients in each group. In conclusion, 7DH clearly improves the detection and allows a better characterization of ventricular arrhythmic episodes but seems to be less useful for supraventricular events.
Francisco J Pastor-Pérez; Sergio Manzano-Fernández; Rebeca Goya-Esteban; Domingo A Pascual-Figal; Oscar Barquero-Pérez; Jose Luis Rojo-Alvarez; Maria Dolores Martinez Martinez-Espejo; Mariano Valdés Chavarri; Arcadio García-Alberola
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article     Date:  2010-07-23
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  677-81     Citation Subset:  AIM; IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis*,  epidemiology
Cohort Studies
Electrocardiography, Ambulatory / methods*
Heart Failure / diagnosis,  etiology*,  physiopathology
Middle Aged
Myocardial Ischemia / complications*,  diagnosis,  physiopathology
Predictive Value of Tests
Stroke Volume
Time Factors
Ventricular Dysfunction, Left / diagnosis,  etiology*,  physiopathology

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