PT  - JOURNAL ARTICLE
AU  - Kelly, Amy M.
AU  - Porter, Co-burn J.
AU  - McGoon, Michael D.
AU  - Espinosa, Raul E.
AU  - Osborn, Michael J.
AU  - Hayes, David L.
TI  - Breath-Holding Spells Associated With Significant Bradycardia: Successful Treatment With Permanent Pacemaker Implantation
AID  - 10.1542/peds.108.3.698
DP  - 2001 Sep 01
TA  - Pediatrics
PG  - 698--702
VI  - 108
IP  - 3
4099  - http://pediatrics.aappublications.org/content/108/3/698.short
4100  - http://pediatrics.aappublications.org/content/108/3/698.full
SO  - Pediatrics2001 Sep 01; 108
AB  - Objective. To determine whether children with pallid breath-holding spells associated with bradycardia can be treated safely and successfully with permanent pacemaker implantation.Methods. The records of pediatric patients who had apparent breath-holding spells and associated bradycardia and were treated with permanent pacemaker implantation were reviewed.Results. Ten pediatric patients with apparent breath-holding spells associated with bradycardia were treated with a permanent ventricular demand pacemaker at the Mayo Clinic between 1985 and 1995. Patients had onset of symptoms between ages 6 days and 12 months and presented for evaluation between ages 12 months and 5 years. Duration of spells was 15 seconds to 10 minutes. Medications to prevent spells were unsuccessful. Electrocardiograms documented asystolic pauses of 1.7 to 24 seconds (mean: 11.9 seconds). Permanent ventricular demand pacemakers were implanted at 10 months to 5 years of age (median: 14.5 months): 9 endocardial and 1 epicardial. Three patients required pacemaker revision. At follow-up of 38 to 170 months (median: 65.5), 5 patients had complete resolution of spells, 2 had only mild color change without loss of consciousness or seizure activity, and 3 continued to have minor brief spells.Conclusions. Permanent pacemaker therapy for children with pallid breath-holding spells associated with severe bradycardia is safe, efficacious, and warranted.