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Incidental electrocardiogram abnormalities in children undergoing polysomnography
Ankit Amin1, Maria Paola Mogavero2, Raffaele Ferri3
1University of Washington Department of Pediatrics and Seattle Children's Hospital Seattle, Washington, USA.
Insights
Electrocardiogram abnormalities are uncommon during pediatric polysomnography (PSG) and not linked to cardiac issues or sleep disorders. These incidental findings are more prevalent in male children undergoing PSG.
Area of Science:
- Pediatric Sleep Medicine
- Pediatric Cardiology
- Clinical Electrocardiography
Background:
- Electrocardiogram (ECG) monitoring is standard in pediatric polysomnography (PSG).
- Limited data exist on the prevalence and nature of ECG abnormalities in children during PSG.
- This study addresses the gap in understanding incidental ECG findings in pediatric sleep studies.
Purpose of the Study:
- To report on abnormal electrocardiogram findings identified during pediatric polysomnography.
- To investigate the association of these findings with cardiac disease and sleep disorders.
- To determine demographic patterns, such as sex, in children with ECG abnormalities during PSG.
Main Methods:
- Retrospective review of pediatric polysomnography (PSG) records from a single sleep center.
- Analysis of ECG findings in children with arrhythmias or conduction disturbances.
- Comparison of findings between children with atrioventricular block and premature ventricular contractions.
Main Results:
- Out of 1,235 PSGs, 24 children (1.9%) exhibited ECG abnormalities.
- No significant difference in obstructive apnea-hypopnea index was found between children with abnormalities and the general PSG cohort.
- ECG abnormalities were more common in males, particularly those with atrioventricular block.
Conclusions:
- Incidental ECG abnormalities are rare in pediatric PSG.
- These findings are generally not associated with underlying cardiac disease or sleep disorders.
- Male sex is a potential risk factor for observing ECG abnormalities during pediatric PSG.
Study Objectives:
Monitoring electrocardiogram is an integral component of pediatric polysomnography (PSG). There are limited data regarding arrhythmia and conduction disturbances in the pediatric population undergoing a PSG. In this work we present abnormal electrocardiogram findings during PSG in our sleep center.
Methods:
A retrospective chart review from children who underwent PSG read by a single sleep medicine physician in the last year was carried out. Findings in children without cardiac disease and with first or second degree atrioventricular block were compared to those from children with premature ventricular contractions.
Results:
A total of 1,235 PSGs were included. Twenty-four children (9 girls and 15 boys) aged 2-17 years (median 9 years) were identified with arrhythmias or conduction disturbances (1.9%). Nineteen out of 24 of these children (79.2%) had obstructive apnea-hypopnea index > 1 event/h; this frequency was not significantly different from that found in the whole group of 1,235 children. No statistically significant difference was found between children with atrioventricular block or premature ventricular contractions. Seven out of 9 children with atrioventricular block and 7 out of 10 with premature ventricular contractions had obstructive apnea-hypopnea index > 1 event/h, while 8 children with atrioventricular block out of 9 and 4 out of 10 with premature ventricular contractions were males (Fisher's exact test P = .04). None of the children were found to have a structural or conduction abnormality when referred to cardiology.
Conclusions:
Our study supports that electrocardiogram abnormalities are rare in PSGs of children and not associated with cardiac disease or sleep disorders but appear more commonly in males.
Citation:
Amin A, Mogavero MP, Ferri R, DelRosso LM. Incidental electrocardiogram abnormalities in children undergoing polysomnography. J Clin Sleep Med. 2021;17(12):2393-2398.
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