Use of demand pacemaker in children with Guillain-Barré syndrome and cardiac arrhythmias

We report 2 patients with Guillain-Barré syndrome who exhibited autonomic dysfunction, including lability of blood pressure and heart rate, frequent episodes of profound bradycardia, and occasional asystole. Both patients required insertion of a temporary venous pacemaker which was activated a few times during the following days. The potential need for ventilatory support in patients with Guillain-Barré syndrome is well known; however, death in these patients due to acute cardiovascular failure during autonomic dysfunction continues to occur. The patients' courses emphasize the significance of cardiac monitoring and the potential use of cardiac pacing in Guillain-Barré syndrome patients who exhibit autonomic dysfunction.