[Diagnostic and prognostic efficiency of 24-hour Holter monitoring in patients with syncope]

Med Clin (Barc). 2016 Aug 19;147(4):148-50. doi: 10.1016/j.medcli.2016.03.041. Epub 2016 May 18.
[Article in Spanish]


Background and objective: Syncope is a common condition and complex to diagnose. The yield of the 24h-Holter ECG in this context has not been clearly defined. The aim of this study was to evaluate its diagnostic and prognostic capacity in these patients.

Patients and method: Retrospective study of 6,006 consecutive patients sent to our unit for 24h-Holter ECG monitoring for syncope. We registered the diagnostic findings and abnormal findings potentially related to an arrhythmic cause of syncope. The prognostic endpoint was a combination of death or the need for device implantation (pacemaker or defibrillator) within one year.

Results: 242 patients (4%) presented diagnostic findings and 472 (7.9%) had some abnormal findings. In 328 cases device implantation was necessary within one year, but up to 66% of these patients did not have any relevant findings on the Holter monitoring. A total of 564 patients presented the combined event, including 36.8% of patients with diagnostic findings and 8.2% without them.

Conclusions: 24h-Holter ECG monitoring presents a limited diagnostic and prognostic yield in unselected patients with syncope.

Keywords: Defibrillator; Desfibrilador; Diagnosis; Diagnóstico; Holter; Marcapasos; Mortalidad; Mortality; Pacemaker; Syncope; Síncope.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / mortality
  • Arrhythmias, Cardiac / therapy
  • Defibrillators, Implantable
  • Electrocardiography, Ambulatory*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pacemaker, Artificial
  • Prognosis
  • Retrospective Studies
  • Syncope