Handheld ECG in analysis of arrhythmia and heart rate variability in children with Fontan circulation

Area of Science:

• Pediatric Cardiology
• Biomedical Engineering

Background:

• Children with univentricular hearts face risks of silent arrhythmias and cardiac autonomic dysfunction.
• Early detection is crucial for managing these complex congenital heart conditions.

Purpose of the Study:

• To evaluate the efficacy of intermittent handheld electrocardiogram (ECG) system use.
• To detect silent arrhythmias and assess cardiac autonomic dysfunction in pediatric patients with univentricular hearts.

Main Methods:

• Twenty-seven patients with univentricular hearts underwent 14-day intermittent ECG monitoring using handheld devices.
• Arrhythmia analysis was performed manually, and heart rate variability (HRV) was assessed using Poincaré plots.
• Reference HRV values were established from Holter-ECGs in 41 healthy children.

Main Results:

• One asymptomatic patient was diagnosed with frequent ventricular extra systoles.
• Another patient experienced episodes of supraventricular tachycardia with palpitations.
• Seven patients exhibited reduced heart rate variability, indicating autonomic dysfunction.

Conclusions:

• The handheld ECG system successfully identified asymptomatic arrhythmia in one patient.
• Pooling intermittent recordings from handheld devices is a viable method for detecting arrhythmias and cardiac autonomic dysfunction.