Overnight Holter monitoring in infants hospitalized with bronchiolitis revealed significant arrhythmias in 18%, including sinus arrest, bradycardia, and frequent atrial premature complexes.
Cohort (n=100)
No
Infants hospitalized with bronchiolitis frequently experience transient, asymptomatic arrhythmias such as sinus arrest and bradycardia that typically resolve without the need for pacemaker intervention.
Bronchiolitis is a major cause of respiratory illness in infants. Few studies have demonstrated arrhythmias during bronchiolitis, including bradycardia and atrioventricular block, some requiring pacemaker implantation. However, the association between bronchiolitis and cardiac arrhythmias remains unclear. To investigate the incidence and characteristics of arrhythmias during bronchiolitis in infants under one year of age. A single center, prospective cohort study was conducted on infants hospitalized with a clinical diagnosis of bronchiolitis. Demographic and clinical data were collected via questionnaire. All infants underwent overnight Holter monitoring during hospitalization. Among 100 enrolled infants (79% RSV-positive), 18 (18%) demonstrated arrhythmias: sinus arrest (2–13 seconds) in 8 infants, bradycardia <60 bpm in 7 infants, and frequent atrial premature complexes (APCs; 3%–18% of beats) in 3 infants. Follow-up Holters in 7 patients (38%) showed resolution of arrhythmias within 1–4 months. No significant demographic or clinical predictors were identified. None of the infants exhibited symptoms (e.g., cyanosis, unresponsiveness) associated with arrhythmia severity. Our study shows that bronchiolitis is associated with significant arrhythmias in infants, particularly sinus arrest, bradycardia and APCs. In our cohort, none of the infants with significant arrhythmia required arrhythmia intervention. Clinicians should be aware of this association and consider delaying decisions regarding pacemaker implantation until after the resolution of bronchiolitis even in cases of infants with severe bradycardia. Future investigations should explore the pathophysiology and prognostic implications of this phenomenon.
Raphael et al. (Sun,) conducted a cohort in Bronchiolitis (n=100). Overnight Holter monitoring was evaluated on Incidence and characteristics of arrhythmias. Overnight Holter monitoring in infants hospitalized with bronchiolitis revealed significant arrhythmias in 18%, including sinus arrest, bradycardia, and frequent atrial premature complexes.