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  • Perinatal/Neonatal Case Presentation
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Perinatal/Neonatal Case Presentation

Non-sinus bradyarrhythmias in very low birth weight infants

Abstract

Transient bradycardias occur frequently in preterm infants with apnea of prematurity. However, occurrence of non-sinus bradyarrhythmias in very low birth weight (VLBW) infants has received very little attention. This case series documents transient bradyarrhythmias in VLBW infants. Most frequently observed arrhythmia was a non-sinus atrial rhythm followed by junctional escape rhythm. Ventricular rhythm with wide QRS complexes occurred rarely. The majority of these episodes occurred in the absence of oxygen desaturation. Increase in vagal tone is presumed to mediate this response.

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References

  1. Dransfield DA, Spitzer AR, Fox WW . Episodic airway obstruction in premature infants. Am J Dis Child 1983; 137: 441–443.

    CAS  PubMed  Google Scholar 

  2. Henderson-smart DJ, Butcher-Puech MC, Edwards DA . Incidence and mechanism of bradycardia during apnoea in preterm infants. Arch Dis Child 1986; 61: 227–232.

    Article  CAS  Google Scholar 

  3. Upton CJ, Milner AD, Stokes GM . Episodic bradycardia in preterm infants. Arch Dis Child 1992; 67: 831–834.

    Article  CAS  Google Scholar 

  4. Andriessen P, Koolen AM, Bastin FH, Lafeber HN, Meijler FL . Supraventricular escape rhythms during transient episodes of bradycardia in preterm infants. Cardiol Young 2001; 11: 626–631.

    Article  CAS  Google Scholar 

  5. Park MK . Pediatric Cardiology for Practitioners, 4th edn. Mosby Inc.: St Louis, 2002.

    Google Scholar 

  6. Valimaki I, Tarlo PA . Heart rate patterns and apnea in newborn infants. Am J Obstet Gynecol 1971; 110: 343–349.

    Article  CAS  Google Scholar 

  7. Southall DP, Richards J, Brown DJ, Johnston PG, de Swiet M, Shinebourne EA . 24-Hour tape recordings of ECG and respiration in the newborn infant with findings related to sudden death and unexplained brain damage in infancy. Arch Dis Child 1980; 55: 7–16.

    Article  CAS  Google Scholar 

  8. Gamble Y, Mathew OP . Bradyarrhythmias in premature infants: does vagal inhibitory reflexes play a role [abstract]. PAS 57: 1233.

  9. Sperelakis N, Pappano AJ . Physiology and pharmacology of developing heart cells. Pharmacol Ther 1983; 22: 1–39.

    Article  CAS  Google Scholar 

  10. Church SC, Morgan BC, Oliver Jr TK, Guntheroth WG . Cardiac arrhythmias in premature infants: an indication of autonomic immaturity? J Pediatr 1967; 71: 542–546.

    Article  CAS  Google Scholar 

  11. Phillips SJ, Agate Jr FJ, Silverman WA, Steiner P . cardiac reactivity in premature infants. Biol Neonat 1964; 6: 225–249.

    Article  CAS  Google Scholar 

  12. Mathew OP, Sant'Ambrogio G, Fisher JT, Sant'Ambrogio FB . Respiratory afferent activity in the superior laryngeal nerves. Respir Physiol 1984; 58: 41–50.

    Article  CAS  Google Scholar 

  13. Haddad GG . Respiratory Control in the Newly Born Infant: Comparative Physiology and Clinical Disorders. In: Mathew OP (ed). Respiratory Control and Disorders in the Newborn. Marcel Dekker Inc: New York, 2003, pp 1–15.

    Google Scholar 

  14. Miller MJ, Martin RJ . Pathophysiology of apnea of prematurity. In: Polin RA, Fox WW, Abman SH (eds). Fetal and Neonatal Physiology. Saunders: Philadelphia, 2004, pp 905–918.

    Chapter  Google Scholar 

  15. Mathew OP, Roberts JL, Thach BT . Pharyngeal airway obstruction in preterm infants during mixed and obstructive apnea. J Pediatr 1982; 100: 964–968.

    Article  CAS  Google Scholar 

  16. Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL et al. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med 2006; 173: 910–916.

    Article  Google Scholar 

  17. Ackerman MJ, Siu BL, Sturner WQ, Tester DJ, Valdivia CR, Makielski JC et al. Postmortem molecular analysis of SCN5A defects in sudden infant death syndrome. JAMA 2001; 286: 2264–2269.

    Article  CAS  Google Scholar 

  18. Tester DJ, Ackerman MJ . Sudden infant death syndrome: how significant are the cardiac channelopathies? Cardiovasc Res 2005; 67: 388–396.

    Article  CAS  Google Scholar 

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Correspondence to O P Mathew.

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Gamble, Y., Lutin, W. & Mathew, O. Non-sinus bradyarrhythmias in very low birth weight infants. J Perinatol 27, 65–67 (2007). https://doi.org/10.1038/sj.jp.7211623

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  • DOI: https://doi.org/10.1038/sj.jp.7211623

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