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Respiratory Sinus Arrhythmia in Children With Severe Cyanotic and Pallid Breath-Holding Spells

Department of Pediatrics, Division of Pediatric Neurology, The University of Connecticut, Farmington, Connecticut Children's Medical Center Hartford, CT

Lance Bauer, PhD

Department of Psychiatry at The University of Connecticut, Farmington

David Baxter, BS

Department of Psychiatry at The University of Connecticut, Farmington

In this study we investigated centrally mediated parasympathetic regulation of modulated cardiac vagal tone among children with severe cyanotic and pallid breath-holding spells by examining respiratory sinus arrhythmia. Respiratory sinus arrhythmia was evaluated in 41 children; 17 subjects with cyanotic breath-holding spells (6 boys, 11 girls; mean age 37.1 months), 7 subjects with pallid breath-holding spells (2 boys, 5 girls; mean age 33.0 months), and 17 controls (8 boys, 9 girls; mean age 41.2 months). Subjects had recurrent (more than 3) severe breath-holding spells. Each subject's electrocardiogram was recorded in a quiet room and digitized by an 80386 personal computer during five 1-minute periods. R-R intervals within each 1-minute period were converted to heart rate in 120 successive 0.5-second intervals. The resultant heart rate time series was converted to its underlying frequency composition by a fast Fourier transform and averaged across minutes. Respiratory sinus arrhythmia was defined as the variability in the time series over a frequency range (0.096 Hz to 0.48 Hz) corresponding to a range of respiratory rates from 6 to 30 breaths per minute. ANCOVA adjusting for age and sex was conducted with the subject group as the independent measure. There were no significant differences between subjects with cyanotic breath-holding spells and controls. Pallid breath-holding spell subjects had a marked difference in respiratory sinus arrhythmia from either controls or subjects with cyanotic breath-holding spells, demonstrating less variability in respiratory sinus arrhythmia (P < .042) This study supports the hypothesis that there exists autonomic dysregulation in pallid breath-holding spells, caused by a primary central parasympathetic disturbance distinct from the dysregulation found in cyanotic breath-holding spells. (J Child Neurol 1998;13:440-442).

Journal of Child Neurology, Vol. 13, No. 9, 440-442 (1998)
DOI: 10.1177/088307389801300905


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				F. J. DiMario Jr Prospective Study of Children With Cyanotic and Pallid Breath-Holding Spells Pediatrics, February 1, 2001; 107(2): 265 - 269. [Abstract] [Full Text]