{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T18:26:28Z","timestamp":1782152788555,"version":"3.54.5"},"reference-count":72,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:sec id=\"jah310924-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Ambulatory electrocardiography has been in clinical use for 5 decades. However, reference limits for rhythm parameters in healthy infants, children, and adolescents have not been adequately defined. We sought to determine these reference ranges using meta\u2010analysis of existing published studies of 24\u2010hour Holter monitoring in healthy pediatric populations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310924-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Multiple literature databases were searched from 1969 to May 2024 for relevant studies. Data extraction and analysis were completed according to the Meta\u2010Analysis of Observational Studies in Epidemiology guidelines. The prevalence of cardiac ectopy and conduction delays along with mean\u00b1SD of heart rates were obtained and grouped by the following age ranges: neonates (birth to 4\u2009weeks), older infants (1\u201312\u2009months), younger children (1\u20136\u2009years), older children (7\u201312\u2009years), and adolescents (13\u201318\u2009years). Ninety\u2010five percent reference ranges for all rhythm variables were estimated in each age group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310924-sec-0003\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Forty\u2010five studies including 3886 participants were identified and analyzed. Minimum, average, and maximum heart rates during Holter monitoring decreased with age as expected. Prevalence of transient first\u2010degree atrioventricular block and Wenckebach second\u2010degree atrioventricular block increased with age to around 14% in adolescence. Prevalence rates for any premature atrial complexes and premature ventricular complexes were also highest in adolescence at 50% and 29%, respectively. The upper limits for the number of premature atrial complexes per day were 150 in infants and 50 in the older age groups and for premature ventricular complexes were 50 in all age groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310924-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Holter monitor age\u2010related reference limits for healthy infants, children, and adolescents are proposed.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039783","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T10:08:02Z","timestamp":1748254082000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Holter Monitor Rhythm Parameters in Healthy Infants, Children, and Adolescents: Defining Reference Limits With Meta\u2010Analysis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0362-855X","authenticated-orcid":false,"given":"James J.","family":"Joyce","sequence":"first","affiliation":[{"name":"Jacksonville Pediatric and Adult Congenital Cardiology","place":["Jacksonville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9726-582X","authenticated-orcid":false,"given":"Soujanya","family":"Bogarapu","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine\u2010Peoria","place":["Peoria, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2635-4785","authenticated-orcid":false,"given":"Collins","family":"Odhiambo","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine","place":["Peoria, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4929-1710","authenticated-orcid":false,"given":"Sunita J.","family":"Ferns","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine\u2010Peoria","place":["Peoria, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5224-2276","authenticated-orcid":false,"given":"Harold L.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"The Cardiovascular Research Foundation","place":["St. Louis, USA"]},{"name":"University of Missouri School of Medicine","place":["Columbia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.8.886"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2006.00067.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12426"},{"key":"e_1_3_2_5_2","first-page":"204","article-title":"The value of Holter monitoring in the assessment of pediatric patients","volume":"7","author":"Hegazy RA","year":"2007","unstructured":"Hegazy RA, Lotfy WN. 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