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[Analysis of arrhythmias using Holter electrocardiographic monitoring in patients with ventricular preexcitation].

BACKGROUND
It is known that patients with preexcitation of ventricles (PE) have a predisposition to paroxysmal supraventricular tachyarrhythmias (PSVT). There is a relatively small amount of knowledge concerning the occurrence and clinical significance of other disturbances of the cardiac rhythm in these patients.


OBJECTIVES
1. To consider the possibility of utilization of Holter monitoring (HM) of electrocardiograms (ECG) in the detection of PSVT; 2. To find out the occurrence and evaluate the significance of other than paroxysmal tachycardias; 3. By means of correlation of subjective complaints with objectively documented arrhythmias to consider the extent, to which the subjective complaints are determined by disturbances of cardiac rhythm.


METHODS
24-hour HM ECG was performed under clinical conditions in 50 patients, 23 male and 27 female patients at the average age of 35 +/- 13 (ranging 15-17) years, with manifestant PE on ECG. 21 (42%) patients with documented PSVT and/or atrial paroxysmal fibrillation (APF) constituted a group with Wolff-Parkinson-White (WPW) syndrome. 29 (58%) patients without these arrhythmias were ranked among the group with WPW pattern. 22 (44%) patients had concomitant organic heart disease (OHD). Each long-term electrocardiographic ECG recording was judged in order to specify the occurrence of individual types of arrhythmias and to perform their quantitative analysis per 24 hours. Subjective complaints presented by patients during HM were correlated with the objectively documented arrhythmias.


RESULTS
Arrhythmias were recorded in HM in 35 (70%) of patients with PE. Supraventricular premature beats (SVPBs) occurred in 32 (64%) and ventricular premature beats (VPBs) in 15 (32%) patients with PE. When comparing the patients with PE and OHD with subjects with PE without OHD, no statistical differences in the occurrence of SVPBs and VPBs as well as in numbers per 24 hours were discovered. PSVT were recorded by HM only in 2 patients, and AV reciprocating echoes in another patient with WPW syndrome. Short runs of atrial tachycardia occurred in 2 patients with WPW syndrome.