Ventricular repolarization changes in children with breath holding spells

Abstract

Objective: Breath holding spells is a non-epileptic paroxysmal disease which is frequently seen in childhood. In this study, we aimed to investigate electrocardiographic atrial conduction and ventricular repolarization changes in children with breath holding spells.

Materials and methods: We reviewed the electrocardiograms of 58 patients with breath holding spells who admitted to SBU Okmeydanı SUAM Pediatric Cardiology Clinic between November 2018 and February 2019. QT, QTc (calculated with Bazett formula), T peak-end (Tp-e), QT dispersion (QTd), QTc dispersion (QTcd), Tp-e/QT ratio, Tp-e/QTc ratio, JT interval, JTc (calculated with Bazett formula), Tp-e/JT ratio, Tp-e/JTc ratio and P dispersion (Pd) were measured and compared with the control group of 44 healthy children.

Results: In the control and the case groups, mean QTd was 19.86 ms and 38.57 ms, QTcd was 28.34 ms and 58.03 ms, Tp-e/QT ratio was 0.16 and 0.26, Tp-e/QTc ratio was 0.11 and 0.17, JT interval was 204.09 ms and 224.52 ms, JTc value was 290.00 ms and 333.72 ms, Tp-e/JT ratio was 0.23 and 0.35, Tp-e/JTc ratio was 0.16 and 0.24, Pd was 29.32 ms and 40.53 ms respectively. Differences between two groups were statistically significant (p < 0,001).

Conclusion: QTd, QTcd, Tp-e, Tp-e/QT ratio, Tp-e/QTc ratio, JT, JTc, Tp-e/JT, Tp-e/JTc ratio and Pd were increased significantly compared to healthy children. Based on the results, ventricular repolarization and atrial conduction were affected in patients with breath holding spells. These patients may be under the risk of developing rhythm disorders.

Keywords: Breath holding spells; Ventricular repolarization.