title: Evaluation of the indications and arrhythmic patterns of 24 hour Holter electrocardiography among hypertensive and diabetic patients seen at OAUTHC, Ile-Ife Nigeria.
abstract: BACKGROUND
  There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogram (Holter ECG) in the arrhythmic evaluation of hypertensive and diabetic patients.
  
  
  OBJECTIVE
  To evaluate indications, arrhythmic pattern of Holter ECG, and heart rate variability (HRV) among patients with hypertensive heart disease (HHD) with or without heart failure and type 2 diabetes mellitus (T2DM) seen in our cardiac care unit.
  
  
  METHODS
  Seventy-nine patients (32 males and 47 females) were studied consecutively over a year using Schiller type (MT-101) Holter ECG machine.
  
  
  RESULTS
  Out of the 79 patients, 17 (21.5%) had HHD without heart failure, 33 (41.8%) had HHD with hypertensive heart failure (HHF), while 29 (36.7%) were T2DM patients. The mean (standard deviation) ages of HHD without heart failure, HHF and T2DM patients were 59.65 (±14.38), 65.15 (±14.30), and 54.66 (±8.88) respectively. The commonest indication for Holter ECG was palpitation (38%), followed by syncope (20.3%). Premature ventricular contraction was the commonest arrhythmic pattern among the 79 patients, especially among HHF patients. The HRV using standard deviation of all normal-normal intervals was significantly reduced in T2DM patients (81.03±26.33, confidence interval [CI] =71.02-91.05) compared to the HHD without heart failure (119.65±29.86, CI =104.30-135.00) and HHF (107.03±62.50, CI =84.00-129.19). There was a negative correlation between the duration of T2DM and HRV (r=-0.613).
  
  
  CONCLUSIONS
  Palpitation was the commonest Holter ECG indication and premature ventricular contractions were the commonest arrhythmic pattern among our patients. HRV was reduced in T2DM patients compared with hypertensive patients.
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Rasaaq A
authors.initials: RA
authors.lastname: Adebayo
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Amanze N
authors.initials: AN
authors.lastname: Ikwu
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Balogun
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Akintomide
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Tuoyo O
authors.initials: TO
authors.lastname: Mene-Afejuku
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Victor O
authors.initials: VO
authors.lastname: Adeyeye
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Olaniyi J
authors.initials: OJ
authors.lastname: Bamikole
authors.affiliation: Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Luqman A
authors.initials: LA
authors.lastname: Bisiriyu
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Olufemi E
authors.initials: OE
authors.lastname: Ajayi
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Suraj A
authors.initials: SA
authors.lastname: Ogunyemi
authors.affiliation: Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Omolola A
authors.initials: OA
authors.lastname: Oketona
keywords: Holter electrocardiography; Nigerians; arrhythmias; diabetes mellitus; hypertension