Syncope in Children: Is Rhythm Holter Monitoring Necessary?
Yıl: 2016 Cilt: 14 Sayı: 3 Sayfa Aralığı: 124 - 128 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Syncope in Children: Is Rhythm Holter Monitoring Necessary?
Öz: Giriş: Senkop geçiren hastalarda anamnez, fizik muayene ve elektrokardiyografi (EKG) ile etiyoloji açıklanamıyorsa genellikle Holter monitörizasyonu (HM) yapılır. Bu çalışmada senkoplu çocuklarda HM'nin tanısal değerinin belirlenmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışmada 2010-2014 yılları arasında hastalara uygulanan toplam 3,122 HM retrospektif olarak incelendi. Hastaların cinsiyet, tanı yaşı, ayrıntılı anamnez, fizik muayene, 12-derivasyon EKG ve ekokardiyografik sonuçları standart form kullanılarak kayıt edildi.Bulgular: Çalışmaya yaş ortalaması 13,21±3,67 olan 323 hasta dahil edildi. Hastaların 199'u kız, 124'ü erkek idi. Tüm hastaların 284'ünde (%87,9) Holter sonuçları normal saptanırken 11 hastada (%3,4) senkopu açıklayan anormal Holter sonuçları tespit edildi. Anormal Holter sonuçları olan 11 hastanın üçünde HM öncesinde uygulanan EKG ile tanı konduğu için HM'nin tanısal değeri %2,4 olarak hesaplandı. Aile öyküsü pozitif olan çocuklarda ise HM'nin tanısal değeri %16,6 olarak bulundu. Çalışmada EKG'si normal olan yedi hastada ise HM sonucu ile uzun QT sendromu düşünüldü.
Anahtar Kelime: Konular:
Çocuklarda Senkop: Ritim Holter Monitörizasyonu Gerekli mi?
Öz: Introduction: Holter monitoring (HM) is usually used in patients with syncope when etiology cannot be explained with history, physical examination and electrocardiography (ECG). In this study the objective was to evaluate the diagnostic value of HM in children with syncope.Materials and Methods: Databases were collected retrospectively by analyzing the HM results of 3.122 pediatric patients between 2010-2014. Gender, age at diagnosis, detailed clinical history, physical examination, 12-lead electrocardiographic and echocardiographic results were noted using standardized form.Results: The study included 323 patients with syncope with a mean age of 13.21±3.67. There were 199 female and 124 male patients in this study. Among all patients 284 (87.9%) had normal HM results, while 11 (3.4%) patients had abnormal Holter studies that consider to explain as syncope. Three of 11 patients with abnormal Holter results diagnosed through ECG before HM, hence, the diagnostic value of HM was calculated as 2.4%. In contrast, diagnostic value of HM in patients with positive family history was found to be 16.6%. In this study, 7 patients were considered to have long QT syndrome according to their HM findings. Conclusions: Detailed clinical history has a great value in children with syncope. As a result, HM has low diagnostic value if the patients are not in high risk group. However, HM was considered to be important because of concealed long QT syndrome especially if the patient had positive family history and exercise related syncope.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Brignole M, Menozzi C, Moya A, et al. Mechanism of syncope in patients with bundle branch block and negative electrophysiological test. Circulation 2001;104:2045-50.
- Farwell D, Sulke N. How do we diagnose syncope? J Cardiovasc Electrophysiol 2002;13:S9-13.
- Kapoor WN. Syncope. N Engl J Med 2000;343:1856-62.
- Soteriades ES, Evans JC, Larson MG, et al. Incidence and prognosis of syncope. N Engl J Med 2002;347:878-85.
- Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC. Syncope in children and adolescents. J Am Coll Cardiol 1997;29:1039-45.
- Linzer M, Yang EH, Estes NA, Wang P, Vorperian VR, Kapoor WN. Diagnosing syncope. Part 2: Unexplained syncope. Clinical Efficacy Assessment Project of the American College of Physicians. Ann Intern Med 1997;127:76-86.
- Kuhne M, Schaer B, Moulay N, Sticherling C, Osswald S. Holter monitoring for syncope: diagnostic yield in different patient groups and impact on device implantation. QJM 2007;100:771-7.
- Sarasin FP, Carballo D, Slama S, Louis-Simonet M. Usefulness of 24-h Holter monitoring in patients with unexplained syncope and a high likelihood of arrhythmias. Int J Cardiol 2005;101:203- 7.
- Katritsis DG, Camm AJ. Nonsustained ventricular tachycardia: where do we stand? Eur Heart J 2004;25:1093-9.
- Dolz Aspas R, Samperiz Legarre P, Calvo Begueria E, et al. [Syncope: many studies and few diagnoses?]. Rev Clin Esp 2004;204:9-13.
- Manolis AS, Linzer M, Salem D, Estes NA, 3rd. Syncope: current diagnostic evaluation and management. Ann Intern Med 1990;112:850-63.
- Sheldon R, Rose S, Ritchie D, et al. Historical criteria that distinguish syncope from seizures. J Am Coll Cardiol 2002;40:142-8.
- Sarasin FP, Junod AF, Carballo D, Slama S, Unger PF, Louis- Simonet M. Role of echocardiography in the evaluation of syncope: a prospective study. Heart 2002;88:363-7.
- Gibson TC, Heitzman MR. Diagnostic efficacy of 24-hour electrocardiographic monitoring for syncope. Am J Cardiol 1984;53:1013-7.
- Wohrle J, Kochs M. Syncope in the elderly. Z Gerontol Geriatr 2003;36:2-9.
- Tester DJ, Will ML, Haglund CM, Ackerman MJ. Effect of clinical phenotype on yield of long QT syndrome genetic testing. J Am Coll Cardiol 2006;47:764-8.
- Viskin S, Rosovski U, Sands AJ, et al. Inaccurate electrocardiographic interpretation of long QT: the majority of physicians cannot recognize a long QT when they see one. Heart Rhythm 2005;2:569-74.
| APA | Uysal F, BOSTAN Ö, ÇETİNKAYA F, DENİZ T, ÇİL E (2016). Syncope in Children: Is Rhythm Holter Monitoring Necessary?. , 124 - 128. |
| Chicago | Uysal Fahrettin,BOSTAN Özlem Mehtap,ÇETİNKAYA Fatma,DENİZ Tuba,ÇİL Ergun Syncope in Children: Is Rhythm Holter Monitoring Necessary?. (2016): 124 - 128. |
| MLA | Uysal Fahrettin,BOSTAN Özlem Mehtap,ÇETİNKAYA Fatma,DENİZ Tuba,ÇİL Ergun Syncope in Children: Is Rhythm Holter Monitoring Necessary?. , 2016, ss.124 - 128. |
| AMA | Uysal F,BOSTAN Ö,ÇETİNKAYA F,DENİZ T,ÇİL E Syncope in Children: Is Rhythm Holter Monitoring Necessary?. . 2016; 124 - 128. |
| Vancouver | Uysal F,BOSTAN Ö,ÇETİNKAYA F,DENİZ T,ÇİL E Syncope in Children: Is Rhythm Holter Monitoring Necessary?. . 2016; 124 - 128. |
| IEEE | Uysal F,BOSTAN Ö,ÇETİNKAYA F,DENİZ T,ÇİL E "Syncope in Children: Is Rhythm Holter Monitoring Necessary?." , ss.124 - 128, 2016. |
| ISNAD | Uysal, Fahrettin vd. "Syncope in Children: Is Rhythm Holter Monitoring Necessary?". (2016), 124-128. |
| APA | Uysal F, BOSTAN Ö, ÇETİNKAYA F, DENİZ T, ÇİL E (2016). Syncope in Children: Is Rhythm Holter Monitoring Necessary?. Güncel Pediatri, 14(3), 124 - 128. |
| Chicago | Uysal Fahrettin,BOSTAN Özlem Mehtap,ÇETİNKAYA Fatma,DENİZ Tuba,ÇİL Ergun Syncope in Children: Is Rhythm Holter Monitoring Necessary?. Güncel Pediatri 14, no.3 (2016): 124 - 128. |
| MLA | Uysal Fahrettin,BOSTAN Özlem Mehtap,ÇETİNKAYA Fatma,DENİZ Tuba,ÇİL Ergun Syncope in Children: Is Rhythm Holter Monitoring Necessary?. Güncel Pediatri, vol.14, no.3, 2016, ss.124 - 128. |
| AMA | Uysal F,BOSTAN Ö,ÇETİNKAYA F,DENİZ T,ÇİL E Syncope in Children: Is Rhythm Holter Monitoring Necessary?. Güncel Pediatri. 2016; 14(3): 124 - 128. |
| Vancouver | Uysal F,BOSTAN Ö,ÇETİNKAYA F,DENİZ T,ÇİL E Syncope in Children: Is Rhythm Holter Monitoring Necessary?. Güncel Pediatri. 2016; 14(3): 124 - 128. |
| IEEE | Uysal F,BOSTAN Ö,ÇETİNKAYA F,DENİZ T,ÇİL E "Syncope in Children: Is Rhythm Holter Monitoring Necessary?." Güncel Pediatri, 14, ss.124 - 128, 2016. |
| ISNAD | Uysal, Fahrettin vd. "Syncope in Children: Is Rhythm Holter Monitoring Necessary?". Güncel Pediatri 14/3 (2016), 124-128. |
