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Evaluation of the indications and arrhythmic patterns of 24 hour Holter electrocardiography among hypertensive and diabetic patients seen at OAUTHC, Ile-Ife Nigeria

Authors Adebayo R, Ikwu A, Balogun M, Akintomide A, Mene-Afejuku T, Adeyeye V, Bamikole O, Bisiriyu L, Ajayi O, Ogunyemi S, Oketona O

Received 26 May 2014

Accepted for publication 13 August 2014

Published 26 November 2014 Volume 2014:7 Pages 565—570


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Ming-Hui Zou

Rasaaq A Adebayo,1 Amanze N Ikwu,1 Michael O Balogun,1 Anthony O Akintomide,1 Tuoyo O Mene-Afejuku,1 Victor O Adeyeye,1 Olaniyi J Bamikole,1 Luqman A Bisiriyu,2 Olufemi E Ajayi,1 Suraj A Ogunyemi,1 Omolola A Oketona1

1Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, 2Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria

Background: There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogram (Holter ECG) in the arrhythmic evaluation of hypertensive and diabetic patients.
Objective: To evaluate indications, arrhythmic pattern of Holter ECG, and heart rate variability (HRV) among patients with hypertensive heart disease (HHD) with or without heart failure and type 2 diabetes mellitus (T2DM) seen in our cardiac care unit.
Methods: Seventy-nine patients (32 males and 47 females) were studied consecutively over a year using Schiller type (MT-101) Holter ECG machine.
Results: Out of the 79 patients, 17 (21.5%) had HHD without heart failure, 33 (41.8%) had HHD with hypertensive heart failure (HHF), while 29 (36.7%) were T2DM patients. The mean (standard deviation) ages of HHD without heart failure, HHF and T2DM patients were 59.65 (±14.38), 65.15 (±14.30), and 54.66 (±8.88) respectively. The commonest indication for Holter ECG was palpitation (38%), followed by syncope (20.3%). Premature ventricular contraction was the commonest arrhythmic pattern among the 79 patients, especially among HHF patients. The HRV, using standard deviation of all normal-normal intervals was significantly reduced in T2DM patients (81.03±26.33, confidence interval [CI] =71.02–91.05) compared to the HHD without heart failure (119.65±29.86, CI =104.30–135.00) and HHF (107.03±62.50, CI =84.00–129.19). There was a negative correlation between the duration of T2DM and HRV (r=−0.613).
Conclusion: Palpitation was the commonest Holter ECG indication and premature ventricular contractions were the commonest arrhythmic pattern among our patients. HRV was reduced in T2DM patients compared with hypertensive patients.

Keywords: Holter electrocardiography, arrhythmias, hypertension, diabetes mellitus, Nigerians

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