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Effect of Piracetam and Iron Treatment on Heart Rate Variability in Patients With Breath-Holding Spell
Mehmet Öncül1, Özlem Elkıran2, Cemşit Karakurt3
1Specialist, Department of Pediatric Cardiology Malatya, Malatya Training and Research Hospital, Malatya, Turkey.
Insights
Piracetam treatment significantly improved heart rate variability (HRV) and reduced breath-holding spells in children. Iron therapy showed fewer significant HRV changes. Piracetam is a promising treatment option.
Area of Science:
- Pediatrics
- Cardiology
- Neurology
Background:
- Breath-holding spells affect 3-5% of children aged 6 months to 5 years.
- While generally benign, severe or recurrent cases may be treated with iron or piracetam.
- The study investigated the impact of these treatments on heart rate variability (HRV).
Purpose of the Study:
- To compare heart rate variability (HRV) before and after iron and piracetam treatment in children with breath-holding spells.
- To assess the effectiveness of iron and piracetam in managing breath-holding spells.
- To analyze changes in HRV parameters using 24-hour Holter monitoring.
Main Methods:
- Retrospective evaluation of 25 pediatric patients diagnosed with breath-holding spells.
- Patients received either iron or piracetam therapy.
- 24-hour Holter monitoring was performed before and after treatment.
Main Results:
- Piracetam treatment led to statistically significant improvements in multiple HRV parameters (e.g., mean heart rate, RR interval standard deviation, low frequency).
- Iron treatment showed significant differences only in hourly peak heart rate and total power.
- Patients receiving piracetam experienced a significant decrease in the frequency of breath-holding attacks.
Conclusions:
- Piracetam treatment positively impacts both the efficacy and HRV in patients with breath-holding spells.
- Significant changes in HRV parameters were observed in patients treated with piracetam.
- Piracetam demonstrates efficacy and can be considered a viable treatment for breath-holding spells.
Background:
Breath-holding spells are a benign condition primarily seen in 3% to 5% of healthy children aged between six months and five years. Although no specific treatment is recommended due to its benign nature, iron and piracetam are used in severe or recurrent cases. We planned to compare the heart rate variability (HRV) before and after treatment with 24-hour Holter monitoring in patients receiving iron and piracetam treatment and investigate the treatment's effectiveness.
Methods:
Twenty-five patients who applied to the outpatient clinic between 2013 and 2015 due to breath-holding spells were included in the study. The patients who received piracetam and iron therapy and underwent 24-hour rhythm Holter monitoring were evaluated retrospectively.
Results:
Fourteen (56%) of these patients were evaluated as having cyanotic-type and 11 (44%) patients were assessed as having pale-type breath-holding spells. A significant difference was found only between hourly peak heart rate and total power in the group receiving iron treatment. Significant differences were also found among the minimum heart rate, mean heart rate, the standard deviation of RR intervals, the mean square root of the sum of the squares of their difference between adjacent RR intervals, spectpow, and low frequency before and after the treatment in the patients who started piracetam treatment (P < 0.05).
Conclusions:
Our study is critical as it is the first to investigate the effects of treatment options on various HRV in patients with breath-holding spells. There were statistically significant changes in HRV parameters in patients receiving piracetam, and the number of attacks decreased significantly. Piracetam treatment contributes positively to the breath-holding spell with regard to efficacy and HRV, therefore it can be used to treat breath-holding spells.
