Breath-holding spells associated with significant bradycardia: Successful treatment with permanent pacemaker implantation

Amy M. Kelly, Co Burn J. Porter, Michael D. McGoon, Raul E. Espinosa, Michael J. Osborn, David L. Hayes

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

Objective. To determine whether children with pallid breath-holding spells associated with bradycardia can be treated safely and successfully with permanent pacemaker implantation. Methods. The records of pediatric patients who had apparent breath-holding spells and associated bradycardia and were treated with permanent pacemaker implantation were reviewed. Results. Ten pediatric patients with apparent breath-holding spells associated with bradycardia were treated with a permanent ventricular demand pacemaker at the Mayo Clinic between 1985 and 1995. Patients had onset of symptoms between ages 6 days and 12 months and presented for evaluation between ages 12 months and 5 years. Duration of spells was 15 seconds to 10 minutes. Medications to prevent spells were unsuccessful. Electrocardiograms documented asystolic pauses of 1.7 to 24 seconds (mean: 11.9 seconds). Permanent ventricular demand pacemakers were implanted at 10 months to 5 years of age (median: 14.5 months): 9 endocardial and 1 epicardial. Three patients required pacemaker revision. At follow-up of 38 to 170 months (median: 65.5), 5 patients had complete resolution of spells, 2 had only mild color change without loss of consciousness or seizure activity, and 3 continued to have minor brief spells. Conclusions. Permanent pacemaker therapy for children with pallid breath-holding spells associated with severe bradycardia is safe, efficacious, and warranted.

Original languageEnglish (US)
Pages (from-to)698-702
Number of pages5
JournalPediatrics
Volume108
Issue number3
DOIs
StatePublished - Sep 6 2001

Keywords

  • Bradycardia
  • Breath-holding spells
  • Pacemaker

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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