Introduction and objectives: Palpitations and syncope are complaints that are often worrisome for patients and cardiologists alike. Although mostly benign, these symptoms may be the prodrome of significant cardiac events. The purpose of this study was to formulate an association between such symptoms and the frequencies of arrhythmias, in different age groups, as identified by a 24 hour holter monitor recording.
Methods: . The data was analyzed through SPSS version 18.0. 844 Patients from various age groups, of either gender, referred for Holter monitoring with symptoms of palpitations and syncope were evaluated for arrhythmias. Descriptive statistics were used to summarize the categorical variables in frequencies and percentages while the continuous variables were reported as mean and standard deviation. Proportion difference was observed between categorical variables using Chi-square independent test. P-value <0.05 was considered as significant.
Results: The majority of patients belonged to the 57-75 age group (35.2 %). 41.7 % of patients were females. We identified 59 subjects with VT and an equal percentage with wide QRS tachycardia. 33 patients were identified to have CHB. 45 % of patients with syncope had an underlying arrhythmia. The most common arrhythmia amongst these patients was PSVT (27.7%). More patients complained of palpitations as a symptom but only 34.8% had an underlying arrhythmia. The most common arrhythmia amongst these patients was paroxysmal supra-ventricular tachycardia (21.8%) and Paroxysmal AF (8.0 %). Patients with palpitations more commonly had a sustained arrhythmia as compared to patients with syncope. Sinus arrhythmia, AF, VT and wide QRS tachycardia were more common in patients with palpitations, whereas heart blocks and sinus bradycardia were more common in patients with syncope. Wide QRS tachycardia, AV blocks, sustained and non sustained supraventricular arrhythmias were more common in the elderly population (75 +) whereas sinus arrhythmia was most common in patients younger than 19. The most common arrhythmia in the elderly population was AF
Conclusions: 21.2 % of patients had symptoms during the recording period, out of which only 9.4 % correlated with the underlying arrhythmia. Ambulatory ECG monitoring can provide diagnostic, prognostic and therapeutic information only in some situations. Not all patients with an underlying rhythm abnormality had symptoms during the recording period.