open access

Vol 15, No 4 (2008)
Review articles
Published online: 2008-05-21
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Prognostic value of Holter monitoring in congestive heart failure

Iwona Cygankiewicz, Wojciech Zaręba, Antoni Bayes de Luna
Cardiol J 2008;15(4):313-323.

open access

Vol 15, No 4 (2008)
Review articles
Published online: 2008-05-21

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

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
Get Citation

Keywords

congestive heart failure; Holter monitoring; risk stratification; heart rate variability; heart rate turbulence; repolarization dynamics

About this article
Title

Prognostic value of Holter monitoring in congestive heart failure

Journal

Cardiology Journal

Issue

Vol 15, No 4 (2008)

Pages

313-323

Published online

2008-05-21

Bibliographic record

Cardiol J 2008;15(4):313-323.

Keywords

congestive heart failure
Holter monitoring
risk stratification
heart rate variability
heart rate turbulence
repolarization dynamics

Authors

Iwona Cygankiewicz
Wojciech Zaręba
Antoni Bayes de Luna

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