Shai Tejman-Yarden1, Bruria Ben-Zeev2, Yuval Goldshmit3, Georgia Sarquella-Brugada4, Assi Cicurel5, Uriel Katz2, David Mishali2, Michael Glikson6. 1. The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel. Electronic address: tegmanya@gmail.com. 2. The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel. 3. Medtronic LTD, Tel Aviv, Israel. 4. Servicio de Cardiología Pediátrica, Hospital Clínic-Sant Joan de Déu, University of Barcelona, Esplugues de Llobregat, Spain. 5. Clalit Health Services, and The Department of Family Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. 6. Davidai Arrhythmia Center, The Heart Center, Sheba Medical Center, Ramat Gan, Israel.
Abstract
BACKGROUND: Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia. PATIENT DESCRIPTION: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia. PATIENT DESCRIPTION: 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. RESULTS: 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. CONCLUSION: 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.