The Burden of Arrhythmias and Conduction Abnormalities Among Patients Presenting With Palpitations at a Cardiac Specialist Care Center in Ghana: A Retrospective Cross‐Sectional Study

ABSTRACT Background and Aims Palpitation is one of the commonest presenting complaints to the hospital. The underlying problem may or may not be cardiac. Symptoms may not be present at the time of hospital presentation, and the patient's resting electrocardiogram (ECG) may be normal. In such cases, Holter ECG becomes a valuable tool for evaluating these patients. Methodology This 12‐year retrospective cross‐sectional study determined the prevalence of arrhythmias and conduction abnormalities among patients who presented to a specialist cardiac clinic with palpitations and underwent 24‐h Holter ECG monitoring between 2010 and 2022. Data were summarized using descriptive statistics. Also, binary logistic regression models, adjusted for age, sex and comorbidity, were used to examine associations between clinical characteristics and Holter ECG outcomes. Results A total of 495 patients were included in the study. Overall, 223 (45.1%) had significant arrhythmia. Frequent ectopic beats were present in 159 (32.0%). Supraventricular ectopic beats and ventricular ectopic beats of any frequency were present in 483 (97.6%) and 402 (81.2%), respectively. Other arrhythmias included non‐sustained ventricular tachycardia (5.5%), atrial fibrillation (1.8%), Mobitz II atrioventricular block (2.2%), sinus pause (> 2 s, 14.9%), and sinoatrial node block/arrest (2.8%). Significant arrhythmias were more likely with advancing age (adjusted odds ratio (aOR) = 11.022, 95% confidence interval (CI): 1.008–1.036, p = 0.002), whilst frequent ectopic beats were also more likely with advancing age (aOR 1.017, CI 1.002–1.031, p = 0.026) and with the presence of heart failure (aOR = 1.917, 95% CI = 1.048–3.506, p = 0.035). Conclusion Holter ECG is a valuable tool for evaluating patients with palpitations. Nearly half of the patients showed significant arrhythmia on Holter ECG monitoring.