Pattern of Arrhythmia among Hypertensive Patients in South-South, Nigeria: A 24-H Ambulatory ECG (Holter ECG) Study

Chibuike Eze Nwafor *

Cardiology Unit, Department of Medicine, University of Port Harcourt and University of Port Harcourt Teaching Hospital, Nigeria.

Otonye Briggs

Research Unit, Good Heart Medical Consultants, Nigeria.

*Author to whom correspondence should be addressed.


Background: Regular 12-lead electrocardiogram (ECG) often fail to detect cardiac conduction abnormalities. Among hypertensive patients, conduction irregularities such as atrial fibrillation and ventricular tachycardia are recognized occurrences and these can be intermittent or asymptomatic. This study aims to evaluate the conduction abnormalities identified among hypertensives by Holter ECG in a private medical facility in South-South, Nigeria.

Methods: This is a retrospective study of five hundred and thirteen patients consisting of 255 males and 258 females Holter ECG who presented at a private medical facility from January 2015- December 2016. Holter ECG data was acquired using Schiller type (MT-101) Holter ECG Machine.

Results: Out of the 370 hypertensive patients reviewed, with a mean age of 55.18 ±.14.78, 205(55.41%) had tachycardia, 180(48.65%) had bradycardia, 184(49.73%) had ventricular ectopics while 169(45.68%) had supraventricular ectopics. The most common clinical indication was palpitation 150 (40.54%). The most prevalent age group was 41-60 years; 230 (44.83%) as compared to other age groups in the study.  Tachycardia was the most common type of arrhythmia among the subjects. There was a higher incidence of arrhythmias in the female subjects than in the male. 

Conclusion: Tachycardia and ventricular ectopics were the most common conduction abnormalities observed. Beta blockers and anti-arrhythmics would be helpful for optimization of cardiovascular care. Holter ECG is beneficial in describing and characterizing arrhythmias in hypertensive patients in this population therefore, further studies on larger populations and diverse disease conditions are advocated.

Keywords: 24-hour ambulatory holter electrocardiography, cardiac arrhythmias, hypertension, hypertensive patients, cardiovascular complications

How to Cite

Nwafor, C. E., & Briggs , O. (2024). Pattern of Arrhythmia among Hypertensive Patients in South-South, Nigeria: A 24-H Ambulatory ECG (Holter ECG) Study. Asian Journal of Medicine and Health, 22(6), 6–11.


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Adebayo RA, Ikwu AN, Balogun MO, Akintomide AO, Ajayi OE, Adeyeye VO, et al. Heart rate variability and arrhythmic patterns of 24-hour Holter electrocardiography among Nigerians with cardiovascular diseases. Vasc Health Risk Manag. 2015 Jun 29;11:353–9.

Chundusu CM, Akanbi MO, Onuh JA, Amusa GA, Danbauchi SS, Okeahialam BN. Descriptive evaluation of holter recordings at a teaching hospital in central Nigeria. Highl Med Res J. 2015;15(2):59–62.

ACC/AHA Guidelines for Ambulatory Electrocardiography: Executive Summary and Recommendation | Circulation [Internet]. [cited 2024 Jan 27]. Available:

Adebola PA, Daniel FA, Ajibare AO, Reima AE. Prevalence of arrhythmias on 24-h ambulatory Holter electrocardiogram monitoring in LASUTH: A report on 414 patients. Niger J Cardiol. 2020 Jun;17(1):61.

Use of Ambulatory Electrocardiographic (Holter) Monitoring | Annals of Internal Medicine [Internet]. [cited 2024 Jan 27]. Available:

Adebayo RA, Ikwu AN, Balogun MO, Akintomide AO, Mene-Afejuku TO, Adeyeye VO, et al. Evaluation of the indications and arrhythmic patterns of 24 hour Holter electrocardiography among hypertensive and diabetic patients seen at OAUTHC, Ile-Ife Nigeria. Diabetes Metab Syndr Obes Targets Ther. 2014 Nov 26;7:565–70.

Takase B, Kurita A, Noritake M, Uehata A, Maruyama T, Nagayoshi H, et al. Heart rate variability in patients with diabetes mellitus, ischemic heart disease, and congestive heart failure. J Electrocardiol. 1992 Apr 1;25(2):79–88.

M G, S B, J F, M D, P M, B D, et al. [Prognostic value of ventricular arrhythmia in hypertensive patients]. Arch Mal Coeur Vaiss. 1997 Aug 1;90(8):1049–53.

Yiu KH, Tse HF. Hypertension and cardiac arrhythmias: a review of the epidemiology, pathophysiology and clinical implications. J Hum Hypertens. 2008 Jun;22(6):380–8.

Sultana R, Sultana N, Rashid A, Rasheed SZ, Ahmed M, Ishaq M, et al. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension. J Ayub Med Coll Abbottabad.

Adebola AP, Daniel FA, Lasisi GT, Ogunleye O. 24-Hour Holter Monitoring at the Lagos State University Teaching Hospital –A Report of 85 Cases. Niger J Clin Med [Internet]. 2009 [cited 2024 Feb 23];2(2). Available:

Gregoratos G, Abrams J, Epstein AE, Freedman RA, Hayes DL, et al. ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Summary Article. Circulation. 2002 Oct 15;106(16):2145–61.

Olamoyegun MA, Oluyombo R, Iwuala SO, Asaolu SO. Epidemiology and patterns of hypertension in semi-urban communities, south-western Nigeria. Cardiovasc J Afr. 2016 Dec 23;27(6):356–60.

Bigger JT, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation. 1984 Feb;69(2):250–8.

Pagani M, Malfatto G, Pierini S, Casati R, Masu AM, Poli M, et al. Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy. J Auton Nerv Syst. 1988 Aug 1;23(2):143–53.

Zimetbaum P, Goldman A. Ambulatory arrhythmia monitoring. Circulation. 2010 Oct 19;122(16):1629–36.