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The Value of Holter Monitoring in Evaluating the Elderly Patient Who Falls
Author(s) -
Rosado Juan A.,
Rubenstein Laurence Z.,
Robbins MPH, Alan S.,
Heng Ming K.,
Schulman Barbara L.,
Josephson Karen R.
Publication year - 1989
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1989.tb02639.x
Subject(s) - medicine , ambulatory , supraventricular arrhythmia , cardiology , electrocardiography , heart disease , atrial fibrillation
Ambulatory cardiac (Holter) monitoring is often recommended in the routine evaluation of patients who fall; however, the prevalence of arrhythmias in old people is high, and the usefulness of such monitoring is unproven. As part of a large study of institutionalized elderly fallers, we compared Holter findings of fallers (N = 51) with a group of nonfallers (N = 27) having similar medical and demographic characteristics. Prevalence of ventricular arrhythmias was 82% in each group, and all patients had supraventricular arrhythmias. The mean number of ventricular and supraventricular couplets and runs did not differ between groups. There was no difference in severity of arrhythmias between fallers and nonfallers; in fact, fallers had slightly fewer Lown 4B arrhythmias than nonfallers (10% vs 18%, NS). Prevalence of heart disease was 78% in both groups and was associated with increased ventricular ectopy in the form of runs and couplets (P < .05). No symptoms were reported during the Holter monitoring. We conclude that Holter monitoring should not be a routine part of the work‐up of the patient who falls.