Transient Episodes Of Bradycardia Research Articles

A rare event of trigeminocardiac reflex during mandibular branch of trigeminal nerve radiofrequency ablation

We at Our Pain Clinic witnessed a rare event of recurrent bradycardia and hypotension during radiofrequency ablation of mandibular division of trigeminal nerve. A 48-year-old lady with trigeminal neuralgia in left V3 distribution was posted for V3 division rhizotomy under fluoroscopy. The patient had transient episodes of bradycardia and hypotension during the procedure. The patient had transient episodes of bradycardia and hypotension during the procedure. HR and BP were reverted to baseline with injection atropine and intravenous fluids. This response is most likely attributed to trigemino cardiac reflex, which occurs due to inadvertent stimulation of trigeminal nerve.

Supraventricular Escape Rhythms During Bradycardia in Preterm Infants 18

Background: In transient episodes of bradycardia (TEBs) the P axis (Pax) gives information about the pacemaker site. Atrial escape (AER) and AV nodal escape rhythm (AVER) have a different Pax than sinus rhythm (SR).Methods: 19 spontaneously breathing healthy preterm infants were studied: GA 29.2 ± 1.9 w; BW 1154 ± 264 g; postnatal age range 3-28 d. 5-Lead ECGs were registered (mean registration time 2.5 h/infant) and sampled by a Physics Data Acquisition System (PhyDAS). To evaluate our methodology the PhyDAS Pax was compared with a standard ECG (stdECG) Pax during SR. TEBs were defined as periods of 3 or more RR-intervals being at least 25% longer than the preceding baseline intervals. During TEBs the PhyDAS Pax was used to classify bradyarrhythmias. A TEB with a Pax range from 0 to+90 ° was considered to be a sinusbradycardia (SB). A Pax range from +90 to +360 ° indicated AER. The absence of P wave or P wave following QRS complex indicated AVER. The RR-interval was expressed as the instantaneous heart rate (IHR). The RR-interval preceding AER or AVER was normalized for its mean baseline interval (nrmRR). Statistics: results as mean ± SD, Wilcoxon test. Mann-Whitney test. Results: During SR the PhyDAS Pax was correlated with the stdECG Pax (50 ± 11 degrees: range 29-68; r=0.82; p<0.0001). In 11 pts 60 TEBs were observed. In 28 TEBs (47%) the Pax remained between 0 to +90 °. During 20 TEBs (33%) in 9 pts the Pax deviated outside the 0 to +90 ° range. During 5 TEBs (8%) in 4 pts AVER developed. 7 TEBs (12%) could not be classified. IHR was significantly lower in AVER (46 + 5 bpm) than in SB (80 ± 18 bpm; p=0.001) or AER (69± 15 bpm; p=0.004) The nrmRR was significantly longer preceding AVER(3.5 ± 0.4) than in SB (2.0 + 0.6: p=0.002) or before AER (2.3 ± 0.6; p=0.003).

Apnea, transient episodes of bradycardia, and periodic breathing in preterm infants

• The occurrence of central apnea of 15 seconds or longer, transient episodes of bradycardia (TEB), and periodic breathing were studied in 66 healthy premature infants when at least 1 week old and between 32 and 36 weeks postconceptual age. Eight-hour cardiorespiratory recordings were visually scanned for the presence of thesee patterns. Central apnea of 15 seconds or longer was seen in almost half of the infants. The TEB were numerous, and the majority were not associated with central apnea; however, all but five of the apneic episodes that lasted 15 seconds or longer were accompanied by a TEB. Infants spent as much as 40% of their time in periodic breathing. The frequency with which these patterns are seen in healthy premature infants strongly suggests that they are normal findings. Our results do not support the opinion that brief periods of apnea are abnormal when accompanied by a TEB. (AJDC. 1990;144:54-57)

Apnea, Transient Episodes of Bradycardia, and Periodic Breathing in Preterm Infants

The occurrence of central apnea of 15 seconds or longer, transient episodes of bradycardia (TEB), and periodic breathing were studied in 66 healthy premature infants when at least 1 week old and between 32 and 36 weeks postconceptual age. Eight-hour cardiorespiratory recordings were visually scanned for the presence of these patterns. Central apnea of 15 seconds or longer was seen in almost half of the infants. The TEB were numerous, and the majority were not associated with central apnea; however, all but five of the apneic episodes that lasted 15 seconds or longer were accompanied by a TEB. Infants spent as much as 40% of their time in periodic breathing. The frequency with which these patterns are seen in healthy premature infants strongly suggests that they are normal findings. Our results do not support the opinion that brief periods of apnea are abnormal when accompanied by a TEB.