The significance of diagnostic aspects of Holter ECG monitoring in verifying the causes of syncopal states in young patients (clinical cases)

  • N.M. Chirka
  • L.M. Vakolyuk National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Keywords: syncope, Holter monitoring, ECG, life-threatening rhythm disturbance.


Annotation. Fainting (syncope) in a given period of life occurs in almost a third of the population, but only in a small number of cases it is a manifestation of a serious disease. The purpose of this observation is to determine the causes of unconscious conditions in young people without a painful history and the absence of any other clinical manifestations and pathological changes in generally accepted laboratory and instrumental examinations. Holter daily ECG monitoring is today considered one of the most important and most effective ways to diagnose heart rhythm disturbances. This article discusses two cases of syncope in young people. The first clinical case occurred in a guy 24 years old. On an outpatient basis, a survey was conducted. All indicators were within the standard values. The patient was diagnosed with Syncopal conditions of unknown origin. When examining the results of ECG monitoring, the cause of syncope was discovered and established. She turned out to be an intermittent form of AV blockade of the II degree of the II type of highly frequent. The patient was recommended to establish an ECS de mand. The second clinical case occurred in a young patient 40 years old. In this patient, with the help of monitoring, a paroxysmal form of ventricular fibrillation was diagnosed. In these two cases, which we examined in this article, only Holter ECG monitoring is of little diagnostic value for verification of syncope in young patients.


1. Yevropeiska asotsiatsiia pediatrychnoi kardiolohii ta vrodzhenykh vad sertsia (AEPC) (2016). Rekomendatsii Yevropeiskoho tovarystva kardiolohiv 2015 roku shchodo likuvannia patsiientiv z shlunochkovymy arytmiiamy za zapobihannia raptovoi sertsevoi smerti [European Association of Pediatric Cardiology and Congenital Heart Defects (AEPC) (2016). Recommendations of the European Society of Cardiology 2015 on the treatment of patients with ventricular arrhythmias for the prevention of sudden cardiac death]. Dodatok do zhurnalu “Arytmolohiia” – Supplement to the journal Arrhythmology. Kyiv.

2. Zharinov, O. Y. (2010). Kholterivske ta frahmentarne monitoruvannia EKH [Holter and fragment ECG monitoring]. Kyiv. Vziato z

3. Kovalenko, V. N., & Sychev, O. S. (2009). Narushenie serdechnogo ritma i provodimosti. Rukovodstvo dlya vrachej [Violation of heart rhythm and conduction. A guide for doctors]. Kiev.

4. Kushakovskij, M. S. (1998). Aritmii serdca (rasstrojstva serdechnogo ritma i narusheniya provodimosti. Prichiny, mehanizmy, elektrokardiograficheskaya i elektrofiziologicheskaya diagnostika, klinika. Lechenie). Rukovodstvo dlya vrachej (izd. 2-e, dop.) [Cardiac arrhythmias (heart rhythm and conduction disorders. Causes, mechanisms, electrocardiographic and electrophysiological diagnostics, clinic. Treatment). A guide for doctors (ed. 2, add.)]. SPb: IKF “Foliant”. Vzyato s

5. Mostovyi, Yu. M. (Red.). (2011). Suchasni klasyfikatsii ta standarty likuvannia rozpovsiudzhenykh zakhvoriuvan vnutrishnikh orhaniv (13-te vyd., dop. i pererob.) [Modern classifications and standards for the treatment of common diseases of the internal organs (13th ed., Supplement and rework)]. Vinnytsia: DP “Derzhavna kartohrafichna fabryka”. Vziato z URI:

6. Okorokov, A. N. (2002). Diagnostika boleznej vnutrennih organov. (Tom 6). Diagnostika serdca i sosudov [Diagnosis of diseases of internal organs. (Vol. 6). Diagnosis of the heart and blood vessels]. Moskva: Medicinskaya literatura. Vzyato s

7. Sychev, O. S. (Red.). (2010). Aritmologiya i elektrofiziologiya. Sbornik lekcij v shemah i tablicah [Arrhythmology and electrophysiology. Collection of lectures in diagrams and tables]. Kiev.

8. WebCardio (2015). Klinichnyi protokol nadannia medychnoi dopomohy khvorym z A-V blokadoiu [Clinical protocol for the provision of medical care for patients with AV blockade]. Elektronnyi naukovo-praktychnyi zhurnal pro kardiolohiiu – An electronic scientific and practical journal on cardiology. Vziato z http//www.webcardio/orq.
How to Cite
Chirka, N., & Vakolyuk, L. (2019). The significance of diagnostic aspects of Holter ECG monitoring in verifying the causes of syncopal states in young patients (clinical cases). Reports of Vinnytsia National Medical University, 23(4), 621-624.