Vol 15, No 4 (2008)
Review Article
Published online: 2008-05-21
Prognostic value of Holter monitoring in congestive heart failure
Cardiol J 2008;15(4):313-323.
Abstract
Congestive heart failure (CHF) is an increasingly widespread, costly and deadly disease,
frequently named as epidemics of the 21 century. Despite advancement in modern treatment,
mortality rate in CHF patients remains high. Therefore, risk stratification in patients with
CHF remains one of the major challenges of contemporary cardiology. Electrocardiographic
parameters based on ambulatory Holter monitoring have been documented to be independent
risk predictors of total mortality and progression of heart failure. Recent years brought an
increased interest in evaluation of dynamic Holter-derived ECG markers reflecting changes in
heart rate and ventricular repolarization behavior. It is widely accepted that structural changes
reflecting myocardial substrate are better identified by means of imaging techniques, Holter
monitoring on the other hand provides complementary information on myocardial vulnerability
and autonomic nervous system. Therefore, combining the electrocardiographic stratification
with assessment of myocardial substrate may provide the complex insight into interplay between
factors contributing to death.
The present article reviews the literature data on the prognostic role of various Holter-based ECG parameters, with special emphasis to dynamic ECG risk markers - heart rate variability, heart rate turbulence, repolarization dynamics and variability - in predicting mortality, as well as different modes of death in patients with CHF
The present article reviews the literature data on the prognostic role of various Holter-based ECG parameters, with special emphasis to dynamic ECG risk markers - heart rate variability, heart rate turbulence, repolarization dynamics and variability - in predicting mortality, as well as different modes of death in patients with CHF
Keywords: congestive heart failureHolter monitoringrisk stratificationheart rate variabilityheart rate turbulencerepolarization dynamics