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Evaluation of Heart Rate Variability in Children With Breath-Holding Episodes

Azza Al-Shahawy1, Doaa El Amrousy1, Ahmed Abo Elezz1

  • 1Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Pediatric Neurology
|December 31, 2018
PubMed

Insights

Heart rate variability is significantly increased in children experiencing pallid breath-holding episodes (BHEs). This evaluation is crucial for managing BHEs, particularly the pallid type.

Area of Science:

  • Pediatric Cardiology
  • Autonomic Nervous System Function
  • Cardiorespiratory Events

Background:

  • Breath-holding episodes (BHEs) are common in children.
  • BHEs are categorized into cyanotic and pallid types.
  • Autonomic dysfunction may underlie BHEs.

Purpose of the Study:

  • To evaluate heart rate variability (HRV) in children with BHEs.
  • To compare HRV parameters between cyanotic BHEs, pallid BHEs, and healthy controls.

Main Methods:

  • Sixty children with BHEs (42 cyanotic, 18 pallid) and 60 controls underwent 24-hour Holter monitoring.
  • Evaluated parameters included heart rate, corrected QT interval, and time-domain HRV metrics.
  • HRV assessed using standard deviation of all R-R intervals, RMSSD, and pNN50.

Main Results:

  • Children with pallid BHEs exhibited significantly higher HRV time-domain parameters compared to cyanotic BHEs and controls.
  • Pallid BHE group showed significantly lower minimum, mean, and maximum heart rates.
  • Asystole and prolonged corrected QT were observed in some children with pallid BHEs.

Conclusions:

  • Heart rate variability is significantly elevated in children with pallid BHEs.
  • HRV assessment is vital for managing children with BHEs, especially the pallid subtype.
Abstract

Keywords:
Autonomic dysregulationBreath-holding episodesHeart rate variabilityLong QTPallid episode

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