Holter Monitoring In Critically Ill Non-Cardiac Patients
Journal Title: National Journal of Medical and Dental Research - Year 2017, Vol 5, Issue 2
Abstract
Introduction:Holter monitoring is widely used non invasive test to evaluate electrocardiographic abnormalities of patients in a variety of cardiac and non-cardiac diseases. It has been observed that critically ill (cardiac and non-cardiac) patients are at increased risk of arrhythmias, silent ischemia and sudden cardiac death. We want to study the association between critically ill non cardiac patients and cause of sudden cardiac death and chances of developing arrhythmias in such patients. Aims and objectives: To study arrhythmias in critically ill Non-Cardiac patients. ST segment Changes. To study Heart Rate Variability in critically ill Non Cardiac patients. Methods : The total of 45 out of which 30 were male and 15 female ,Critically ill NONCARDIAC patients above 12 years age such as OP Poisoning, meningitis, intracranial bleed, subdural hematoma, Guillian barre syndrome, hepatic encephalopathy, Etc. admitted in tertiary care institute were selected for Holter monitoring , by using 2.3 Channel, Holter monitor, Forest Medical Systems, LLC, USA. Results :A total of 45 patients were monitored by 24 hours Holter monitoring for arrhythmias, silent ischemia and heart rate variability (HRV) in critically ill non-cardiac patients.Out of 45 patients, 25 were on ventilator. Age more than or equal to 40 years was important risk factor for the development of arrhythmia and ST-T changes. Silent ischemia was present, as documented by Holter monitor in 11 patients, of them, majority were on ventilator. Some form of arrhythmias were presents in majority of patients. Those on ventilator had higher incidence of arrhythmia like ventricular ectopic, supraventricular tachycardia. Ventricular fibrillation was exclusively seen in patient on ventilator. Majority of patients on ventilator had depressed HRV. Depressed heart rate varitability (SDNN<100ms) was associated with development of arrhythmias. During Holter monitoring 4 patients died, all of them died because of cardiac arrhythmia followed by cardiac arrest. One of them was on ventilator and developed silent ischemia followed by Ventricular fibrillation and cardiac arrest.
Authors and Affiliations
Pankaj M Bagde, Sanjay N Bhasme
Keywords
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