Effect Of Different Time Holter On The Detection Rate Of Arrhythmia In Patients With Chronic Heart Failure

Objective: To compare the difference of detection rate of arrhythmia in patients with chronic heart failure by Holter of different detection time.Methods: Patients with chronic heart failure were enrolled in this study.After clinical Data were collected and analyzed,the patient will go through a continuous 72-hour ambulatory electrocardiogram(72h Holter)monitoring,Then we'll Compare supraventricular and ventricular arrhythmia detection rate among the 24 hours,48 Hours and 72 hours Holter.Patients with chronic heart failure were further divided into subgroups according to NYHA classification,eject ion fraction and pro-BNP level.The cumulative incidence of non-sustained ventricular tachycardia will compared between 24 hours Holter and 72 hours Holter in the subgroup.Results: In the patients with chronic heart failure,the analysis of 72-hour ambulatory ECG data revealed a s ignificant statistical difference(P <0.01)between 48 hours(81.7%)and 24 hours(64.6%)in the detection rate of non-sustained atrial tachycardia(NSAT);for the detection of new-onset paroxysmal atrial fibrillation,only 1 case was detected in 24 hours monitoring,An additional 3 cases were detected after monitoring to 72 hours.There were s ignificant differences in the detection rate of non-sustained ventricular tachycardia(NSVT)between 72 hours(38%)and 24 hours(25.9%)(P <0.01);comparing by different sub-groups,we found that detection rate of NSVT increased with the severity of heart failure.There is a statistical difference between 72 h Holter and 24 h Holter on detection rate of NSVT in patient with NYHA class III heart failure,but there is no statistical difference in patient with NYHA class IV heart failure.In patients without the symptoms of heart failure,there is no statistical difference between 15 patients(60%)of 72 h Holter and 10 patients(40%)of 24 h Holter in the detection of non-sustained atrial fibrillation(NSAT)(P> 0.05).Atrial fibrillation and NSVT were not detected in the 72 h Holter monitoring.Conclusion: In these study we found that there is no higher detection rate of arrhythmia in patients without heart failure symptoms by prolonging the ambulatory ECG monitoring time(48h Holter/72 h Holter).There is a higher detection rate of arrhythmia in heart failure by prolonged holter(48h Holter/72 h Holter).But the severer heart failure is,the easier NSVT will be found.As for advanced heart failure,if NSVT is not detect by 24 h Holter,the detection time can be prolonged to detect more NSVT.