{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T03:20:04Z","timestamp":1788664804998,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2011,4,20]],"date-time":"2011-04-20T00:00:00Z","timestamp":1303257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:p><jats:italic>\n            <jats:bold>Background:<\/jats:bold> Long QT syndrome (LQTS) is a potentially lethal cardiac channelopathy that affects one in 2,000 persons; causes syncope, seizures, and sudden death; and is both under\u2010 and overdiagnosed. LQTS diagnostic miscues have stemmed from assessment of ambulatory electrocardiographic monitoring (Holter) results.<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Objective:<\/jats:bold> We sought to determine the prevalence of positive Holter monitor tests and its diagnostic significance in evaluating LQTS.<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Methods:<\/jats:bold> We performed an institutional review board\u2010approved review of patients evaluated in our LQTS clinic from 2000 to 2009 who had Holter testing during their evaluation. Included patients (N = 473) were diagnosed with LQTS or dismissed as otherwise normal. Holters classified as positive had an episode of nonsustained ventricular tachycardia, supraventricular tachycardia, \u22654 couplets\/day, \u226510 premature ventricular contractions\/hour, or &gt;5\u2010second sinus pause.<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Results:<\/jats:bold> Among 209 patients dismissed as normal (128 females, average age 21 \u00b1 15 years, average QTc 424 \u00b1 39 ms), 27 (12.9%) had a positive Holter, while among 264 patients with LQTS (149 females, average age 22 \u00b1 16 years, average QTc 472 \u00b1 41 ms), 30 (11.3%) had a positive Holter (P = NS). Patients with LQT3 (5\/23, 21%) and genotype\u2010negative LQTS (5\/19, 26%) had a higher rate of positive Holter testing compared to LQT1 patients (7\/124, 6%, P &lt; 0.03). Among the 473 Holters, only one (0.2%) impacted clinical decision making.<\/jats:italic><\/jats:p><jats:p><jats:italic>\n            <jats:bold>Conclusion:<\/jats:bold> Routine Holter monitoring appears to be of minimal clinical utility from a diagnostic and prognostic perspective in evaluating LQTS, and may not be cost effective. Whether Holter monitoring aids in therapeutic decisions such as dosing or whether ambulatory QTc measurements, provided by some newer devices, might help in the diagnostic evaluation warrants further scrutiny. 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