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Assessment of heart rate variability in breath holding children by 24 hour Holter monitoring

Published online by Cambridge University Press:  19 December 2013

Osman Yilmaz ,
Murat Ciftel ,
Kezban Ozturk ,
Omer Kilic ,
Hasan Kahveci ,
Fuat Laloğlu  and
Ozben Ceylan
Osman Yilmaz
Affiliation:
Department of Pediatric Cardiology, Erzurum District Training and Research Hospital, Erzurum, Turkey
Murat Ciftel
Affiliation:
Department of Pediatric Cardiology, Erzurum District Training and Research Hospital, Erzurum, Turkey
Kezban Ozturk
Affiliation:
Department of Pediatrics, Erzurum District Training and Research Hospital, Erzurum, Turkey
Omer Kilic*
Affiliation:
Department of Pediatric Infectious Diseases, Erzurum District Training and Research Hospital, Erzurum, Turkey
Hasan Kahveci
Affiliation:
Department of Neonatology, Erzurum District Training and Research Hospital, Erzurum, Turkey
Fuat Laloğlu
Affiliation:
Department of Neonatology, Erzurum Nenehatun Obstetrics and Gynecology Hospital, Erzurum, Turkey
Ozben Ceylan
Affiliation:
Department of Pediatric Cardiology, Suleymaniye Maternity Training and Research Hospital, Istanbul, Turkey
*
Correspondence to: O. Kilic, Department of Pediatric Infectious Diseases, Erzurum District Training and Research Hospital, Erzurum, Turkey. Tel: +90 442 2325364; Fax: +90 442 2325090; E-mail: omerkilic7@yahoo.com
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Abstract

Purpose: Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells. Methods: We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells – 56 cyanotic type and 12 pallid type – and 39 healthy controls. Results: Clinical and heart rate variability results were compared between each spell type – cyanotic or pallid – and the control group; significant differences (p<0.05) in standard deviation of all NN intervals, mean of the standard deviations of all NN intervals for all 5-minute segments, percentage of differences between adjacent RR intervals >50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups. Conclusions: Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes.

Keywords

Breath holdingpallid breath holdingautonomic dysregulationheart rate variabilitysinus pauses
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 2 , February 2015 , pp. 317 - 323
Copyright
© Cambridge University Press 2013 

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