Key result
Breath holding spells linked to ~15-ms higher QT dispersion in children.
Why the study?
Breath holding spells are common in children and may be associated with prolonged QT syndrome and rhythm abnormalities, but previous studies showed mixed results regarding QT dispersion differences.
Case-Control (n=112)
No
Absolute Event Rate: 61.6% vs 47.1%
p-value: p=<0.001
Increased QT dispersion may signal arrhythmia risk in breath-holding spells; hypothesis-generating and should not change practice without prospective validation.
OBJECTIVE: Breath holding spells (BHS) are common involuntary reflexes in infancy and early childhood. Differential diagnosis should embrace Long QT Syndrome (LQTS) and paroxysmal abnormalities of rhythm. The aim of this study was to compare QT dispersion (QTd) in children with breath holding spells and normal controls. MATERIALS & METHODS: QT dispersion and Corrected QT(QTc) dispersion were measured in 12 lead surface electrocardiograms in 56 patients with BHS and compared with healthy children of the same age referred to the clinic for regular checkup visits. RESULTS: The most common type of BHS was cyanotic (83.9%). Seven patients (12.5%) had pallid and two patients (3.5%) had mixed spells. There was a history of breath holding spells in 33.9% of the children. QT dispersion was 61.6± 22.5 and 47.1±18.8 ms in patient and control groups, respectively. QTc dispersion (QTcd) was 104 ± 29.6 and 71.9 ±18.2 ms, respectively. There was a significant difference between patient and control groups in terms of QTd and QTcd (P<0.001). CONCLUSION: QTd and QTcd were increased in children with BHS. Therefore, the evaluation of EKG for early diagnosis of rhythm abnormalities seems reasonable in these children.
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Movahedian et al. (2016) conducted a case-control in Breath Holding Spells (BHS) (n=112). Breath holding spells vs. Healthy controls was evaluated on QT dispersion (QTd) (p=<0.001). Children with breath holding spells had significantly increased QT dispersion compared to healthy matched controls (61.6 ms vs 47.1 ms, P<0.001).
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