New Insights in Pediatric Holter Monitoring and Interpretation

Table of Contents

Part I: Background
1. The beginnings of ECG Holter monitoring
2. Updated technical principles of Holter monitoring
3. New algorithms of Arrhythmia detection and signal interpretation
4. Artefacts
5. New indications of ECG Holter monitoring
6. Poincare graphs and Lorenz plots

Part II: Clinical Cases
7. Case 1: How to differentiate between paroxysmal supraventricular tachycardia and sinus tachycardia?
8. Case 2: A newborn with frequent episodes of atrial tachycardia
9. Case 3: Focal atrial tachycardia in a neonate
10. Case 4: High-burden premature ventricular contractions in a newborn
11. Case 5: Blocked atrial premature contractions in a newborn
12. Case 6: Outflow tract PVCs in a neonate
13. Case 7: PVCs and fusion beats in a neonate
14. Case 8: A 2-month-old girl with paroxysmal supraventricular tachycardia
15. Case 9: An 8-year-old girl with high burden PVCs
16. Case 10: An 8-year-old football player with asymptomatic WPW syndrome
17. Case 11: Low atrial rhythm in a 9-year-old girl
18. Case 12: Asymptomatic WPW syndrome in a 16-year-old football player
19. Case 13: Paroxysmal supraventricular tachycardia in a 12-year-old girl
20. Case 14: Two accessory pathways revealed by one Holter ECG
21. Case 15: Change in the nighttime distribution of PVCs after beta-blockers
22. Case 16: WPW syndrome with paroxysmal SVT captured on Holter ECG
23. Case 17: An 8-year-old girl presenting with Fascicular VT
24. Case 18: Benign Accessory pathway
25. Case 19: Sinus tachycardia in a 12-month-old boy with Prader Willi Syndrome
26. Case 20: A 14-year-old boy with PVCs
27. Case 21: Postero-septal accessory pathway with long refractory period
28. Case 22: Paroxysmal SVT with left bundle branch block
29. Case 23: A 6-year-old boy with accessory pathway
30. Case 24: Premature ventricular contractions with balanced distribution during daytime and nighttime
31. Case 25: Premature ventricular contractions with favorable response to Amiodarone but not to betablockers
32. Case 26: Premature ventricular contractions treated with Vitamin D

Authors

Gabriel Cismaru Rehabilitation Hospital Cluj-Napoca, Romania.

Gabriel Cismaru MD, PhD is a qualified cardiologist working at the Rehabilitation Hospital Cluj-Napoca in Romania. He obtained his PhD in medicine with a research thesis on electrophysiology and pro-arrhythmic drugs. He began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu, France, after finishing his cardiology certification in Clermont-Ferrand and Dinan, France. He began working in the Rehabilitation Hospital's Electrophysiology Laboratory in 2011. He is an experienced surgeon who implants pacemakers, CRTs, and ICDs, as well as performing catheter ablation of supraventricular and ventricular arrhythmias. He is qualified in pediatric cardiology, regularly performing device implantation and catheter ablation in children. Dr. Cismaru has authored or co-authored peer-reviewed publications and book chapters on cardiac pacing, defibrillation, electrophysiological studies, and catheter ablation. He is the author of the book Arrhythmia Induction in the EP Lab," now in its fourth edition.

Simona Cainap Emergency Clinical Hospital for Children Cluj-Napoca, Romania.

Dr. Simona Sorana Cainap MD, PhD is an Associate Professor in Pediatric Cardiology at the University of Medicine and Pharmacy Cluj Napoca, where she serves as an expert on pediatric cardiology, lecturers, and makes use of her extensive echocardiography competence. She is qualified as a primary pediatrician, with training in juvenile diabetes. She enjoys echocardiography, Holter monitoring, training resident doctors, and pursuing clinical work. She has received a vast amount of additional training, and has published widely in peer-reviewed journals.

Cecilia Lazea Emergency Clinical Hospital for Children, Romania.

Cecilia Lazea MD, PhD is a Associate Professor of Pediatrics based in Cluj-Napoca, Romania. Her expertise is pediatric cardiology, and she has made significant contributions to the field through her research and clinical practice. She has explored the genetic factors involved in the development of congenital heart defects, and her research sheds light on transcription factors and signaling molecules that play crucial roles in cardiac development. She has participated in large-scale studies examining low atrial rhythm in children. Dr. Lazea evaluated circulating chitotriosidase activity in children with obesity, providing insights into potential biomarkers related to metabolic health. She also collaborated on research investigating anatomical-MRI correlations in both adults and children with hypertrophic cardiomyopathy.