The Contribution of the 24-Hour EKG Holter in Heart Failure in the Cardiology Department of the Pr Bocar Sidy Sall Hospital of Kati

Heart failure (HF) is defined as the inability of the heart to provide sufficient blood flow to meet the body’s metabolic needs and/or at the cost of increased filling pressures. It is complicated by rhythm disorder, thromboembolic accidents, and sudden death in 50% of cases [1] with a lethality of 10% [2]. The existence of rapid or slow cardiac rhythm disorders may be responsible for heart failure with or without underlying cardiopathy. One of the methods to detect these rhythm disorders is the long-term recording of the rhythm by the Holter EKG [3]. In Mali, very few studies have addressed the contribution of the Holter EKG in the management of heart failure and also the lack of data at the University Hospital of Kati motivated this work. Methods: This is a cross-sectional, descriptive, prospective study, conducted from January 01, 2023 to December 31, 2023, in patients hospitalized for heart failure in the cardiology department of CHU BSS in Kati. All these patients benefited from a 12-lead surface electrocardiogram (EKG), a cardiac ultrasound and a 24-hour EKG Holter. Results: We included 34 patients with an average age of 56.15 years with a sex ratio (M/F) of 1.63. Left ventricular stroke fraction was reduced in 70.6%. We found at the Holter ECG 94% of ventricular extrasystole (ESV), 97% of supraventricular extrasystole (ESSV), 15% of unsupported ventricular tachycardia (VT) and 12% of conduction disorder. In our study, 55.9% of patients were classified as Lown class IV. The present study did not allow us to highlight a correlation between the presence of unsupported VT and the risk of sudden death (P: 0.9). The most frequent complications were thromboembolic events with 60% and the mortality rate was 11%. Conclusion: the Holter EKG allows us to better highlight cardiac arrhythmias, especially ventricular at risk of sudden death in patients with heart failure.