To Örebro University

One hundred and forty four ambulatory, non-emergent human subjects from 20-88 years of age were investigated followingroutine 24 hour Holter monitoring referred by primary and tertiary care centers primarily for evaluation of palpitationsand syncope. The patients were grouped into 3 different age categories: a) 20-59 years of age (16%), B) 60-69 yearsof age (26.4%) and C) > 70 years of age (57.6%). Heart rate profile, RR intervals, symptoms, frequency of prematuresupra ventricular and ventricular complexes were registered. The data show that though the occurrence and frequencyof premature atrial and ventricular contractions over a period of 24 hours did not differ between the groups, the youngersubjects documented more subjective discomforts during the Holter monitoring. Extra-systoles in excess of 1000 beats / 24hour occured incessantly throughout the registration. patients with syncope and those without did not differ as regards theHolter variables. However, subjects with atrial fibrillation had acceptable rate control and had significantly lower incidenceof syncope than those with sinus rhythm. The findings suggest that in a county setting, Holter monitoring for evaluation ofsyncope may not be the first hand mode of investigation in a non emergent setting. on the contrary, the modality appearsto be valuable for monitoring patients with atrial fibrillation. Even mild symptoms in the elderly population may warrant closerclinical follow up to prevent cardiac events and/or syncope leading to serious physical injury.