ArticleBMC cardiovascular disorders2025
Holter-detected arrhythmias and associated risk factors in hospitalized elderly patients with diagnosed heart failure.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to investigate the prevalence, characteristics, and associated clinical factors of arrhythmias-particularly atrial fibrillation (AF) and high-grade premature ventricular contractions (PVCs)-as detected by 24-hour Holter ECG monitoring in hospitalized elderly patients with diagnosed heart failure with ejection fraction ≤ 50%.
methodsA cross-sectional study was conducted between May 2023 to March 2024 at the Cardiovascular Institute, 108 Central Military Hospital, Hanoi, Vietnam. A total of 72 hospitalized patients aged ≥ 65 years with confirmed heart failure (LVEF < 50%) were enrolled. Clinical characteristics, laboratory data, echocardiographic parameters, and 24-hour Holter monitoring results were collected. Multivariable logistic regression with stepwise forward selection (p-entry < 0.2) was used to identify predictors of AF and high-grade PVCs (Lown grade III-V).
resultsThe mean age was 73.7 ± 8.9 years, and 66.7% were male. AF was detected in 19.4% of patients, while a high PVC burden was common, with a median (25th -75th ) of 1955 (54-38514) and 58.3% falling into Lown grades III-V. Multivariable analysis identified increased body mass index (OR = 1.71, 95% CI: 1.18-2.48, p = 0.005) and elevated systolic pulmonary artery pressure (sPAP) (OR = 1.06, 95% CI: 1.00-1.13, p = 0.049) as independent predictors of AF. For high-grade PVCs, significant predictors included elevated sPAP (OR = 1.06, 95% CI: 1.01-1.12, p = 0.024), lower creatinine (OR = 0.99, 95% CI: 0.98-1.00, p = 0.014).
conclusionAF and high-grade PVCs are common in hospitalized elderly patients with diagnosed heart failure and are associated with distinct clinical and laboratory parameters. Elevated sPAP was a shared predictor of both arrhythmias. These findings support the use of integrated echocardiographic and Holter monitoring for risk stratification and management in this population.
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