title: Prediction of the oculocardiac reflex from pre-operative linear and nonlinear heart rate dynamics in children.
abstract: This study was aimed to determine whether pre-operatively measured linear and nonlinear analysis of heart rate variability might predict the occurrence of the oculocardiac reflex (OCR) or other arrhythmia during strabismus surgery in children (n = 185, mean (SD) age = 8.09 (3.31) years). We compared time- and frequency-domain, and nonlinear dynamic indices of pre-operatively measured RR interval data between the OCR-positive group (maximum heart rate decrement = 20 beat.min-1 during the traction of extraocular muscle, n = 54), OCR-negative group (< 20 beat x min(-1), n = 78) and arrhythmia-positive group (all other arrhythmias; n = 53). pNN50, rMSSD, high-frequency power and nonlinear prediction error were significantly lower in the OCR-positive and arrhythmia-positive groups than in the OCR-negative group. Discriminant analysis using these indices could correctly identify 39/54 (72.2%) OCR-positive patients. Some pre-operatively measured indices of linear and nonlinear heart rate variability, especially when used in combination, are valuable for predicting significant bradycardia during strabismus surgery in children.
authors.affiliation: Department of Anaesthesiology, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Kim
authors.forename: S D
authors.initials: SD
authors.lastname: Kim
authors.forename: C S
authors.initials: CS
authors.lastname: Kim
authors.forename: M K
authors.initials: MK
authors.lastname: Yum
mesh_terms: D000293:Adolescent; D001919:Bradycardia / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology*; D011300:Preoperative Care / Q000379:methods*; D012024:Reflex, Oculocardiac / Q000502:physiology*; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D013285:Strabismus / Q000601:surgery*