title: Assessment of heart rate variability in breath holding children by 24 hour Holter monitoring.
abstract: OBJECTIVE
  Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells.
  
  
  METHODS
  We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells - 56 cyanotic type and 12 pallid type - and 39 healthy controls.
  
  
  RESULTS
  Clinical and heart rate variability results were compared between each spell type - cyanotic or pallid - and the control group; significant differences (p<0.05) in standard deviation of all NN intervals, mean of the standard deviations of all NN intervals for all 5-minute segments, percentage of differences between adjacent RR intervals >50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups.
  
  
  CONCLUSIONS
  Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes.
authors.affiliation: 1Department of Pediatric Cardiology,Erzurum District Training and Research Hospital,Erzurum,Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Yilmaz
authors.affiliation: 1Department of Pediatric Cardiology,Erzurum District Training and Research Hospital,Erzurum,Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ciftel
authors.affiliation: 2Department of Pediatrics,Erzurum District Training and Research Hospital,Erzurum,Turkey.
authors.forename: Kezban
authors.initials: K
authors.lastname: Ozturk
authors.affiliation: 3Department of Pediatric Infectious Diseases,Erzurum District Training and Research Hospital,Erzurum,Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Kilic
authors.affiliation: 4Department of Neonatology,Erzurum District Training and Research Hospital,Erzurum,Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kahveci
authors.affiliation: 5Department of Neonatology,Erzurum Nenehatun Obstetrics and Gynecology Hospital,Erzurum,Turkey.
authors.forename: Fuat
authors.initials: F
authors.lastname: Laloğlu
authors.affiliation: 6Department of Pediatric Cardiology,Suleymaniye Maternity Training and Research Hospital,Istanbul,Turkey.
authors.forename: Ozben
authors.initials: O
authors.lastname: Ceylan
mesh_terms: D001049:Apnea / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D062485:Breath Holding; D016022:Case-Control Studies; D002675:Child, Preschool; D003490:Cyanosis / Q000209:etiology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D010167:Pallor / Q000209:etiology; D054138:Sinus Arrest, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
keywords: sinus pauses