Clinical Use of Electrocardiography (ECG) in Children with Breath-Holding Spells

Background and objective: Breath holding spell (BHS) is one of the most common benign non-epileptic paroxysmal attacks in children triggered by a provocative action such as emotional distress and partial damage, and continues with breath-holding, cyanosis and syncope. This study aimed to compare the electrocardiographic components and the demographic data of children with BHS and healthy children. Materials and Methods: In this prospective and cross-sectional study, the population consisted of 60 children with BHS were selected as case group and 60 healthy children as controls who were the same in terms of age and sex. ECG was taken from all children, along with a history of previous spells and demographic information, by a researcher-made questionnaire at Amirkabir Hospital. Finally, the results were analyzed using SPSS V24 software. Results: Echocardiography was normal in all children (n = 120) and did not show any abnormality. The studied population consisted of 69 females and 51 males with no significant difference in their mean age (p <0.05). Among 60 children with BHS in the current study, 68.33% had cyanotic, 11.67% had pallid and 20% had mixed BHS. Anemia was also significant between the two groups. By calculating the mean values ​​of P wave, PR segment, T wave, P and QRS amplitude, there was no significant difference between two groups of children with BHS and healthy children, while there was a significant difference between them in other ECG parameters. Conclusion: Conclusion: According to the results of this study, familial history and anemia can have a positive effect on children with BHS. As BHSs are similar to some hazardous conditions such as long QT syndrome, evaluating electrocardiographic parameters is required in addition to clinical examinations and demographic information in children with BHS. And given that no research has been conducted on children with BHS in their adulthood, it is recommended to check the risk of cardiovascular diseases in these individuals in adulthood so that if such complications are observed, more attention should be paid to BHS treatment.