Significance of isolated bradycardia detected by home monitoring.
OBJECTIVE
To determine the cause of isolated bradycardia during home cardiorespiratory monitoring.


METHODS
A tertiary care hospital.


METHODS
A retrospective review of the charts of 8 patients with severe isolated bradycardia on their home monitoring reports. All subjects underwent polysomnography including a pH probe.


RESULTS
Monitor reports showed a characteristic pattern of long (30 to 60 seconds) periods of bradycardia, sometimes with asystole, associated with irregular respiratory efforts. All patients had severe gastroesophageal reflux, with a pH <4 for 63% +/- 22% (mean +/- SD) of recording time. No patient had other abnormalities to explain the bradycardia. Bradycardia resolved after successful treatment of reflux.


CONCLUSIONS
A pattern of isolated bradycardia associated with irregular respiratory efforts on home monitoring is highly suggestive of gastroesophageal reflux and should prompt further evaluation and treatment.
Marcus
C L
CL
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Hamer
A
A
D001049:Apnea / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D001784:Blood Gas Analysis; D001919:Bradycardia / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010092:Oximetry; D017286:Polysomnography / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies