{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:13:08Z","timestamp":1790050388174,"version":"4.0.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,1,13]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients with Duchenne Muscular Dystrophy (\n              <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>\n              ) develop cardiac fibrosis and dilated cardiomyopathy. We described the frequency of significant Holter findings in\n              <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>\n              , the relationship between cardiac function and arrhythmia burden, and the impact of these findings on clinical management.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A retrospective review was done of patients with\n              <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>\n              who received a Holter from 2010 to 2014. Clinical and arrhythmic outcomes were analyzed. Patients were classified based on left ventricular ejection fraction (\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              ): \u226555%, 35% to 54% and &lt;35%. Significant Holter findings included atrial tachycardia, ventricular tachycardia and atrial fibrillation\/flutter. Logistic regression was used to assess predictors of significant Holter findings and change in care. The study included 442 Holters in 235 patients. Mean age was 14\u00b14 years. Patients with cardiac dysfunction were older, and had increased late gadolinium enhancement and left ventricular dilation (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). There were 3 deaths (1%), all with normal function and none cardiac. Patients with\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              &lt;35% had more arrhythmias including nonsustained atrial tachycardia (\n              <jats:italic>P<\/jats:italic>\n              =0.01), frequent premature ventricular contractions, ventricular couplets\/triplets, and nonsustained ventricular tachycardia (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) compared to the other groups.\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              &lt;35% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) was the only predictor of clinically significant Holter finding. Four patients (40%) had change in medication in the\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              &lt;35% group compared to 9 (3%) in the \u226555% and 4 (4%) in the 35% to 54% groups (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Sudden cardiac events are rare in\n              <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>\n              patients with an\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              &gt;35%. Significant Holter findings are rare in patients with\n              <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>\n              who have an\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              &gt;35%, and cardiac dysfunction appears to predict significant Holter findings. Holter monitoring is highest yield among\n              <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>\n              patients with cardiac dysfunction.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002620","type":"journal-article","created":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T02:58:42Z","timestamp":1451617122000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Ambulatory Monitoring and Arrhythmic Outcomes in Pediatric and Adolescent Patients With Duchenne Muscular Dystrophy"],"prefix":"10.1161","volume":"5","author":[{"given":"Chet R.","family":"Villa","sequence":"first","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Czosek","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humera","family":"Ahmed","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip R.","family":"Khoury","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey B.","family":"Anderson","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy K.","family":"Knilans","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"Jefferies","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Wong","sequence":"additional","affiliation":[{"name":"Comprehensive Neuromuscular Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Spar","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, 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