Assessment of QT Interval Abnormalities on Electrocardiogram in Children With Breath-Holding Spells

Area of Science:

• Pediatric Cardiology
• Clinical Electrophysiology
• Child Health

Background:

• Breath-holding spells are common in young children.
• Abnormalities in cardiac repolarization, such as QT interval variations, can have significant health implications.
• Identifying underlying cardiac conditions is crucial for appropriate management.

Purpose of the Study:

• To investigate QT interval abnormalities in children experiencing breath-holding spells.
• To compare electrocardiogram (ECG) parameters between children with and without breath-holding spells.
• To differentiate ECG findings based on the type of breath-holding spell (pallid vs. cyanotic).

Main Methods:

• A case-control study involving 204 children under 3 years old (104 with breath-holding spells, 100 healthy controls).
• Evaluation of breath-holding spell characteristics: age of onset, type, triggers, frequency, and family history.
• Analysis of 12-lead surface ECG for QT interval (QT), corrected QT interval (QTc), QT dispersion (QTD), and QTc dispersion (QTcD).

Main Results:

• Children with breath-holding spells exhibited significantly prolonged QT, QTc, QTD, and QTcD compared to controls (P<0.001).
• Pallid breath-holding spells were associated with more pronounced prolongation of QT, QTc, QTD, and QTcD than cyanotic spells (P<0.001).
• A significant difference in mean QTc interval was observed between prolonged and non-prolonged QTc groups (P<0.001).

Conclusions:

• Abnormalities in QT, QTc, QTD, and QTcD are prevalent in children with breath-holding spells.
• ECG assessment is strongly recommended, especially for pallid spells, frequent occurrences, early onset, and positive family history.
• This screening can aid in identifying potential cases of long QT syndrome.