Impact of Extended Ambulatory Electrocardiogram Monitoring on Detection Rate of Arrhythmia in Chronic Heart Failure Patients / 中国循环杂志

ABSTRACT

Objective: To compare the detection rate of arrhythmia in chronic heart failure (CHF) patients by different time of ambulatory electrocardiogram (Holter). Methods: A total of 108 consecutive elderly CHF patients received 72h Holter in our hospital from 2016-01 to 2016-09 were enrolled. According to NYHA classification, LVEF and plasma NT-proBNP level, the patients were divided into 3 sets of groups. Detection rates of supra-ventricular arrhythmia and ventricular arrhythmia were compared among 24h, 48h and 72h Holter recording. Results: Based on NYHA classification, the patients were divided into 3 groups NYHA Ⅱ group, n=24, NYHAⅢ group, n=42 and NYHAⅣ group, n=26; based on NT-proBNP level, the patients were divided into 2 groups NT-proBNP≥1000 pg/ml group and NT-proBNP<1000 pg/ml group, n=54 in each group; based on LVEF, the patients were divided into 3 groups HFpEF group, n=80, HFmrEF group, n=13 and HFrEF group, n=15. Detection rate for non-sustained atrial tachycardia (NSAT) was 81.7% by 48h Holter which was higher than 64.6% at 24h, P<0.01; for non-sustained ventricular tachycardia (NSVT) was 38% at 72h which was higher than 25.9% at 24h, P<0.01. For new-onset paroxysmal atrial fibrillation, only 1 patient was detected by 24h Holter and the additional 3 patients were detected by 72h. Group analysis indicated that the detection rate of NSVT was different by 72h and 24h Holter in NYHA Ⅲ patients, P<0.05; while it was similar in NYHA Ⅳ patients, P>0.05. Conclusion: Long term (72h/48h) Holter had the higher detection rate of arrhythmia in HF patients, 24 h monitoring was easier to find NSVT in severer HF patients. In moderate to severe HF patients, the detection time may be prolonged if NSVT couldn't be found by 24h Holter which was helpful for clinical treatment.