title: The Utilization of an Insertable Cardiac Monitor in a Child With Pallid Breath-Holding Spells.
abstract: Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia.
  
  
  
  We describe an 18-month-old girl experiencing severe pallid breath-holding spells in whom repeated electrocardiographic, Holter, and electroencephalographic monitoring tests were all normal.
  
  
  
  Using a subcutaneous insertable cardiac monitor, severe bradycardia was detected during one of this girl's episodes. This finding led to a pacemaker implantation. Subsequently, her breath-holding spells completely resolved.
  
  
  
  This child illustrates the ability of the insertable cardiac monitor to help and diagnose arrhythmias in children with unresolved clinical findings. The ability to implant it with a minimal scar makes it ideal for uncooperative individuals with relative few and unexpected episodes that are hard to diagnose.
authors.affiliation: The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel. Electronic address: tegmanya@gmail.com.
authors.forename: Shai
authors.initials: S
authors.lastname: Tejman-Yarden
authors.affiliation: The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Bruria
authors.initials: B
authors.lastname: Ben-Zeev
authors.affiliation: Medtronic LTD, Tel Aviv, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Goldshmit
authors.affiliation: Servicio de Cardiología Pediátrica, Hospital Clínic-Sant Joan de Déu, University of Barcelona, Esplugues de Llobregat, Spain.
authors.forename: Georgia
authors.initials: G
authors.lastname: Sarquella-Brugada
authors.affiliation: Clalit Health Services, and The Department of Family Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Assi
authors.initials: A
authors.lastname: Cicurel
authors.affiliation: The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Uriel
authors.initials: U
authors.lastname: Katz
authors.affiliation: The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Mishali
authors.affiliation: Davidai Arrhythmia Center, The Heart Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Glikson
mesh_terms: D001049:Apnea / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D001919:Bradycardia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D062485:Breath Holding; D002648:Child; D004567:Electrodes, Implanted; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D018670:Monitoring, Ambulatory
keywords: bradycardia; breath-holding spells; cardiac pacemaker