[Implantable ECG recorder revealed the diagnosis in a baby with apparent life-threatening events]

Abstract

A 14-month-old boy went through episodes of cyanosis and brief loss of consciousness. Extensive investigations failed to lead to a diagnosis, until an implanted ECG recorder revealed ECG abnormalities suggestive of strangulation. Interviews with the father and mother showed that this was indeed the case. The diagnosis of 'Münchhausen by proxy' was made. Psychiatric assistance and home help were called in. The child recovered well. If there is a suspicion of arrhythmia as the cause of apparent life-threatening events, prolonged ECG recordings are necessary. In a clinical environment it is possible to make continuous ECG recordings during a limited period. An insertable recorder allows continuous ECG recordings during a syncopal event and can be used for prolonged monitoring. The patient presented is the youngest infant in the world in whom such a device has been implanted.