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

Abstract

AimWe evaluated heart rate variability in children with breath-holding episodes (BHEs). MethodsSixty children with BHEs were included in the study; these individuals were further subdivided into children with cyanotic BHEs (n = 42) and children with pallid BHE (n = 18). Sixty healthy children of matched age and sex served as a control group. Twenty-four hour Holter monitoring was applied to all included children. Minimum, mean, maximum heart rate, rhythms, and corrected QT were evaluated. Time domain parameters of heart rate variability such as standard deviation of all R-R intervals, standard deviation of the average of R-R intervals in all five-minute segments of the entire recording, mean of the standard deviations of all N-N (normal-normal RR) intervals for all five-minute segments, root mean squares differences between adjacent R-R intervals, percentage of differences between adjacent R-R intervals that are greater than 50 milliseconds were also assessed. ResultsAll time domain parameters of heart rate variability were significantly higher in children with pallid BHEs than those with cyanotic BHEs and control group. Minimum, mean, and maximum heart rate were significantly lower in children with pallid BHEs than those with cyanotic BHEs and control group. Asystole was observed in three children with pallid BHEs. Long corrected QT was observed in another two children with pallid BHEs. ConclusionsHeart rate variability increased significantly in children with pallid BHEs. Evaluation of heart rate variability is crucial for children with BHEs especially those with pallid episodes.