{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:51:33Z","timestamp":1792464693226,"version":"4.5.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Palpitations are a frequent reason for referral to pediatric cardiology providers and diagnostic workup includes ambulatory cardiac monitoring. While common practice, the diagnostic yield is unknown in the pediatric population. The objective is to evaluate the diagnostic yield of 24-h Holter and extended ambulatory cardiac monitoring in pediatric patients with palpitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      All pediatric patients aged 10\u201318 years who had ambulatory cardiac monitoring (1\u201330 days) through the Pocket Electrocardiogram (PocketECG\u2122) system (Medi-Lynx) between January 2016 and July 2020 were included. Patients with an International Classification of Diseases-10 diagnosis code of palpitations (R00.2) during enrollment were evaluated separately. Tachyarrhythmia diagnoses included atrial fibrillation (AF), nonsustained supraventricular tachycardia (nSVT), supraventricular tachycardia (SVT), nonsustained ventricular tachycardia (nVT), and ventricular tachycardia (VT). Age, heart rates, arrhythmia type, and symptomatic transmission data were collected and analyzed. A total of 2388 patients (mean age 11.6 years, 58% F) with the R00.2 code had ambulatory cardiac monitoring (28% 24-h Holter, 72% extended) performed during the study period and there were 6287 total patients (mean age 13.9 years, 54% F) that underwent ambulatory cardiac monitoring (42% 24-h Holter, 58% extended) during that time. Of 2388 patients, 321 (13%) were diagnosed with tachyarrhythmia: AF (9), nSVT (192), SVT (59), and nVT (61). In the overall cohort, 764 (12%) patients were diagnosed with tachyarrhythmia: AF (22), nSVT (478), SVT (85), nVT (177), and VT (2). Symptomatic transmissions with normal cardiac rhythm were common in the R00.2 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1697, 71%) and overall (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3848, 61%) groups. No episodes of nSVT, SVT, nVT, or VT were associated with symptomatic transmissions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Ambulatory cardiac monitors are an integral part of the diagnostic workup for pediatric palpitations patients and have demonstrated a high yield of combined positive arrhythmia diagnoses and symptomatic normal transmissions. Further prospective study of this population with the integration of clinical information is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_107_22","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T01:00:22Z","timestamp":1692234022000},"page":"109-113","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Diagnostic yield of ambulatory cardiac monitoring in pediatric patients with palpitations"],"prefix":"10.4103","volume":"16","author":[{"given":"Lisa","family":"Goto","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital at Montefiore, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Witkowska","sequence":"additional","affiliation":[{"name":"Medicalgorithmics S.A., Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena E.","family":"Slusarczyk","sequence":"additional","affiliation":[{"name":"Medicalgorithmics S.A., Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka M.","family":"Grotek","sequence":"additional","affiliation":[{"name":"Medicalgorithmics S.A., Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek J.","family":"Dziubinski","sequence":"additional","affiliation":[{"name":"Medicalgorithmics S.A., Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley C.","family":"Clark","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Children\u2019s Hospital at Montefiore, Bronx, NY, USA"},{"name":"Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"R1-20240901","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1586\/14779072.4.5.681","article-title":"Minimally invasive approach to the child with palpitations","volume":"4","author":"Rajagopalan","year":"2006","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"R2-20240901","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.ccep.2018.02.010","article-title":"Clinical approach to patients with palpitations","volume":"10","author":"Giada","year":"2018","journal-title":"Card Electrophysiol Clin"},{"key":"R3-20240901","first-page":"204","article-title":"The value of Holter monitoring in the assessment of Pediatric patients","volume":"7","author":"Hegazy","year":"2007","journal-title":"Indian Pacing Electrophysiol J"},{"key":"R4-20240901","doi-asserted-by":"crossref","first-page":"253","DOI":"10.5455\/aim.2016.24.253-256","article-title":"The use of continuous electrocardiographic Holter monitoring in pediatric cardiology","volume":"24","author":"Begic","year":"2016","journal-title":"Acta Inform Med"},{"key":"R5-20240901","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.pcl.2013.09.010","article-title":"The teenager with palpitations","volume":"61","author":"Sedaghat-Yazdi","year":"2014","journal-title":"Pediatr Clin North Am"},{"key":"R6-20240901","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1097\/01.chi.0000231974.43966.6e","article-title":"Somatic symptoms in children and adolescents with anxiety disorders","volume":"45","author":"Ginsburg","year":"2006","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"R7-20240901","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0735-1097(99)00354-X","article-title":"ACC\/AHA Guidelines for ambulatory electrocardiography. A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). Developed in collaboration with the North American Society for Pacing and Electrophysiology","volume":"34","author":"Crawford","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"R8-20240901","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jelectrocard.2015.07.010","article-title":"Smartphone ECG aids real time diagnosis of palpitations in the competitive college athlete","volume":"48","author":"Peritz","year":"2015","journal-title":"J Electrocardiol"},{"key":"R9-20240901","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.1542\/peds.112.3.e228","article-title":"Efficacy of implantable loop recorders in establishing symptom-rhythm correlation in young patients with syncope and palpitations","volume":"112","author":"Rossano","year":"2003","journal-title":"Pediatrics"},{"key":"R10-20240901","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/pace.12835","article-title":"Arrhythmic burden and ambulatory monitoring of pediatric patients with cardiomyopathy","volume":"39","author":"Czosek","year":"2016","journal-title":"Pacing Clin Electrophysiol"},{"key":"R11-20240901","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1007\/s00246-019-02089-0","article-title":"Ambulatory arrhythmia detection with ZIO\u00ae XT patch in pediatric patients:A comparison of devices","volume":"40","author":"Pradhan","year":"2019","journal-title":"Pediatr Cardiol"},{"key":"R12-20240901","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.amjcard.2019.11.028","article-title":"Comparison of Holter with Zio patch electrocardiography monitoring in children","volume":"125","author":"Bolourchi","year":"2020","journal-title":"Am J Cardiol"},{"key":"R13-20240901","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1093\/europace\/eut337","article-title":"Role of extended external loop recorders for the diagnosis of unexplained syncope, pre-syncope, and sustained palpitations","volume":"16","author":"Locati","year":"2014","journal-title":"Europace"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_107_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:12:14Z","timestamp":1787166734000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_107_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_107_22","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]},"assertion":[{"value":"2022-08-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}