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Evaluation of QT Dispersion in Children with Breath Holding Spells
Amir Hosein Movahedian1, Marzieh Heidarzadeh Arani2, Davood Motaharizad3
1Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Children experiencing breath holding spells (BHS) show increased QT dispersion (QTd) and corrected QT dispersion (QTcd) compared to healthy controls. This suggests electrocardiogram (EKG) evaluation is important for diagnosing rhythm abnormalities in these children.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Neurology
Background:
- Breath holding spells (BHS) are common involuntary reflexes in infants and young children.
- Differential diagnosis of BHS includes Long QT Syndrome (LQTS) and paroxysmal rhythm abnormalities.
- Identifying underlying cardiac conditions is crucial for appropriate management.
Purpose of the Study:
- To compare QT dispersion (QTd) and corrected QT dispersion (QTcd) in children with BHS versus healthy controls.
- To investigate potential cardiac rhythm abnormalities associated with BHS.
- To assess the utility of electrocardiogram (EKG) in evaluating children with BHS.
Main Methods:
- A total of 56 children diagnosed with BHS were included.
- QTd and QTcd were measured using 12-lead surface electrocardiograms.
- The BHS group was compared to a control group of healthy children of similar age.
Main Results:
- The majority of BHS were cyanotic (83.9%).
- QTd was significantly higher in the BHS group (61.6±22.5 ms) compared to controls (47.1±18.8 ms).
- QTcd was also significantly elevated in the BHS group (104±29.6 ms) versus controls (71.9±18.2 ms) (P<0.001).
Conclusions:
- Children with BHS exhibit increased QT dispersion (QTd) and corrected QT dispersion (QTcd).
- These findings suggest a potential link between BHS and cardiac rhythm disturbances.
- EKG evaluation for early diagnosis of rhythm abnormalities is recommended in children with BHS.
Objective:
Breath holding spells (BHS) are common involuntary reflexes in infancy and early childhood. Differential diagnosis should embrace Long QT Syndrome (LQTS) and paroxysmal abnormalities of rhythm. The aim of this study was to compare QT dispersion (QTd) in children with breath holding spells and normal controls.
Materials & Methods:
QT dispersion and Corrected QT(QTc) dispersion were measured in 12 lead surface electrocardiograms in 56 patients with BHS and compared with healthy children of the same age referred to the clinic for regular checkup visits.
Results:
The most common type of BHS was cyanotic (83.9%). Seven patients (12.5%) had pallid and two patients (3.5%) had mixed spells. There was a history of breath holding spells in 33.9% of the children. QT dispersion was 61.6± 22.5 and 47.1±18.8 ms in patient and control groups, respectively. QTc dispersion (QTcd) was 104 ± 29.6 and 71.9 ±18.2 ms, respectively. There was a significant difference between patient and control groups in terms of QTd and QTcd (P<0.001).
Conclusion:
QTd and QTcd were increased in children with BHS. Therefore, the evaluation of EKG for early diagnosis of rhythm abnormalities seems reasonable in these children.
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