Çocuk kardiyoloji ünitesinde 24 saatlik ritim holter monitorizasyonu yapılan hastaların değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
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Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışma, 24 saatlik Ritim Holter monitörizasyonunun ( HM) çocuk hastaların tanı ve tedavisindeki değerini belirlemeyi amaçlamaktadır. Kliniğimizde 24 saatlik Ritim Holter monitörizasyonunun hangi endikasyonlar için yapıldığı ve sonuçları gözden geçirilmiştir. Gereç ve Yöntem: 01 Ocak 2015 ile 31 Aralık 2022 tarihleri arasında kliniğimize başvuran 1670 hastanın dosyaları geriye dönük olarak tarandı. Yaş, cinsiyet, başvuru nedeni, kardiyak hastalık varlığı, ailede kardiyak hastalık varlığı, tedavi öyküleri, aile akraba evlilikleri, EKG bulguları, EKO bulguları ve HM bulguları geriye dönük hastane bilgisayarı arşiv dosyalarından değerlendirilerek kaydedildi. Bulgular: Hastaların 870'i erkek (%52,1), 800'ü kız (%47,9) idi. Hastaların yaş gruplarına göre baktığımızda 0-1 yaş 49 hasta (%2.9), 2-5 yaş 120 hasta (%7,2), 6-12 yaş 671 hasta (%40,2) ve 13-18 yaş 830 hasta (%49,7) olarak saptandı. Kliniğe bir semptom ve/veya yakınma ile başvuran 1457 hastanın başvuru yakınmasına göre; 688 hastada (%41,2) çarpıntı, 370 hastada (%22.2) göğüs ağrısı, 265 hastada (%15,9) Çarpıntı+göğüs ağrısı, 133 hastada (%8) Senkop+Presenkop şikayetleri var idi. Konjenital kalp hastalığı olan 86 hastanın 28'inde (%32,6) Opere FT, 19'unda (%22,1) sekundum ASD, 10'unda (%11,7) VSD, 9'unda (%10,5) opere TGA, 7'sinde (%8,1) opere VSD, 6'sında (%7) transkateter yolla kapatılmış ASD , 3'ünde (%3,5) opere PDA, 2'sinde (%2,3) opere arkus aorta hipoplazisi, 1'inde (%1,2) opere ASD ve 1 kişide (%1,2) de küçük PDA mevcut idi. Holter takibi yapılan hastaların 1005'i (%60,2) normal olarak saptandı, 408 (%24,4) hastada taşiaritmi, 85 (%5,1) hastada bradiaritmi, 73 (%4,4) hastada preeksitasyon sendromu, 27 (%1,6) hastada sağ dal bloğu, 27 (%1,6) hastada atriyum kaynaklı aritmi, 12 (%0,7) hastada genetik kaynaklı aritmi, 12 (%0.7) pace ritmi ve 21 (%1,3) hastada ise farklı diğer holter bulguları saptanmıştır. Tartışma: Çocukluk çağında aritmik semptomların çoğunlukla aralıklı olarak ortaya çıkması nedeniyle, başvuru sırasında tespit edilmesi mümkün olmayabilir. İstirahatte çekilen elektrokardiyografi, kardiyak ritmin kısa bir dönemi için bilgi vermekte ve birçok ritm bozukluğu atlanabilmektedir bu nedenle tanı için 24 saatlik holter yönteminin yararlı olduğu düşünülmektedir. Giderek artan sıklıkta kullanılan HM'nin aritmi tanısında, aritmisi olan vakaların izlem ve tedavisinin planlanmasında uygulanması kolay, noninvaziv bir yöntem olarak son derece yararlı olduğu çalışmamızca desteklenmiştir. Anahtar Kelimeler: 24 saatlik ritm holter monitörizasyonu, aritmi, çocuk.
Objective: This study aims to determine the value of Holter monitoring(HM) in the diagnosis and treatment of pediatric patients. İndications for 24-hour Rhytm Holter monitoring in our clinic and its results are reviewed. The indications for HM were reviewed. Materials and Methods: The files of the patients who applied to our clinic between January 01, 2015 and December 31, 2022 were retrospectively scanned. Age, gender, reason for admission, presence of cardiac disease, presence of cardiac disease in the family, treatment histories, family consanguineous marriages, ECG findings, ECHO findings and HM findings were retrospectively evaluated from hospital computer archive files. Results: Of the patients, 870 (52.1%) were boys and 800 (47.9%) were girls. Considering the age groups of the patients, 49 patients (2.9%) aged 0-1, 120 patients aged 2-5 years (7.2%), 671 patients aged 6-12 years (40.2%), and 830 patients aged 13-18 years (%) 49.7). According to the complaint of 1457 patients who applied to the clinic with a symptom and/or complaint; Palpitations were present in 688 patients (41.2%), chest pain in 370 patients (22.2%), palpitation and chest pain in 265 patients (15.9%), syncope or presyncope in 133 patients (8%). Operated FT in 28 (32.6%) of 86 patients with congenital heart disease, secundum ASD in 19 (22.1%), VSD in 10 (11.7%) and 9 (10.5%) operated TGA, 7 (8.1%) operated VSD, 6 (7%) transcatheter closure ASD, 3 (3.5%) operated PDA, 2 (2.3%) operated arch aortic hypoplasia, 1 (1.2%) operated ASD, and 1 (1.2%) small PDA. It was found to be normal in 1005 (60.2%) of Holter follow-up patients, tachyarrhythmia in 408 (24.4%), bradyarrhythmia in 85 (5.1%) patients, preexcitation syndrome in 73 (4.4%) patients, 27 ( Right bundle branch block in 1.6%, atrial origin arrhythmia in 27 (1.6%) patients, genetic arrhythmia in 12 (0.7%) patients, 12 (0.7%) pace rhythm and other holter findings were detected in 21 (1,3%) patients. Discussion: Due to the intermittent occurrence of arrhythmic symptoms in childhood, it may not be possible to detect them at presentation. Electrocardiography taken at rest gives information for a short period of cardiac rhythm and many rhythm disorders can be missed. Therefore, the Holter method is thought to be useful for diagnosis. It has been supported by our study that it is an easy-to-apply, non-invasive method in the diagnosis of HM arrhythmia, which is increasingly used, and in planning the follow-up and treatment of cases with arrhythmia. Keywords: 24-hour rhythm holter monitoring, arrhythmia, children.
Objective: This study aims to determine the value of Holter monitoring(HM) in the diagnosis and treatment of pediatric patients. İndications for 24-hour Rhytm Holter monitoring in our clinic and its results are reviewed. The indications for HM were reviewed. Materials and Methods: The files of the patients who applied to our clinic between January 01, 2015 and December 31, 2022 were retrospectively scanned. Age, gender, reason for admission, presence of cardiac disease, presence of cardiac disease in the family, treatment histories, family consanguineous marriages, ECG findings, ECHO findings and HM findings were retrospectively evaluated from hospital computer archive files. Results: Of the patients, 870 (52.1%) were boys and 800 (47.9%) were girls. Considering the age groups of the patients, 49 patients (2.9%) aged 0-1, 120 patients aged 2-5 years (7.2%), 671 patients aged 6-12 years (40.2%), and 830 patients aged 13-18 years (%) 49.7). According to the complaint of 1457 patients who applied to the clinic with a symptom and/or complaint; Palpitations were present in 688 patients (41.2%), chest pain in 370 patients (22.2%), palpitation and chest pain in 265 patients (15.9%), syncope or presyncope in 133 patients (8%). Operated FT in 28 (32.6%) of 86 patients with congenital heart disease, secundum ASD in 19 (22.1%), VSD in 10 (11.7%) and 9 (10.5%) operated TGA, 7 (8.1%) operated VSD, 6 (7%) transcatheter closure ASD, 3 (3.5%) operated PDA, 2 (2.3%) operated arch aortic hypoplasia, 1 (1.2%) operated ASD, and 1 (1.2%) small PDA. It was found to be normal in 1005 (60.2%) of Holter follow-up patients, tachyarrhythmia in 408 (24.4%), bradyarrhythmia in 85 (5.1%) patients, preexcitation syndrome in 73 (4.4%) patients, 27 ( Right bundle branch block in 1.6%, atrial origin arrhythmia in 27 (1.6%) patients, genetic arrhythmia in 12 (0.7%) patients, 12 (0.7%) pace rhythm and other holter findings were detected in 21 (1,3%) patients. Discussion: Due to the intermittent occurrence of arrhythmic symptoms in childhood, it may not be possible to detect them at presentation. Electrocardiography taken at rest gives information for a short period of cardiac rhythm and many rhythm disorders can be missed. Therefore, the Holter method is thought to be useful for diagnosis. It has been supported by our study that it is an easy-to-apply, non-invasive method in the diagnosis of HM arrhythmia, which is increasingly used, and in planning the follow-up and treatment of cases with arrhythmia. Keywords: 24-hour rhythm holter monitoring, arrhythmia, children.
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
