Long-term outcomes of pediatric sinus bradycardia
Journal
Journal of Pediatrics
Journal Volume
163
Journal Issue
3
Pages
885-8890
Date Issued
2013
Author(s)
Chang C.-W.
Hua Y.C.
Lue H.-C.
Abstract
Objectives: To delineate the long-term outcomes and mechanisms of pediatric sinus bradycardia. Study design: Participants with sinus bradycardia who were identified from a survey of 432?€?166 elementary and high school students, were enrolled 10 years after the survey. The clinical course, heart rate variability, and hyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4) gene were assessed. Results: A total of 104 (male:female was 60:44; prevalence, 0.025%) participants were observed to have sinus bradycardia at age 15.5 ± 0.2 years with a mean heart rate of 48.4 ± 0.4 beats per minute; 86 study participants (83%) responded to clinical assessment and 37 (36%) underwent laboratory assessment. Athletes composed 37.8% of the study participants. During the extended 10-year follow-up, 15 (17%) of the participants had self-limited syncopal episodes, but none had experienced life-threatening events. According to Holter recordings, none of the participants had heart rate <30 beats per minute or a pause longer than 3 seconds. Compared with 67 age- and sex-matched controls, the variables of heart rate based on the spectral and time domain analysis of the participants with sinus bradycardia were all significantly higher, indicating higher parasympathetic activity. The results of mutation analysis were negative in the HCN4 gene in all of our participants. Conclusions: The long-term outcomes of the children and adolescents with sinus bradycardia identified using school electrocardiographic survey are favorable. Parasympathetic hyperactivity, instead of HCN4 gene mutation, is responsible for the occurrence of sinus bradycardia. ? 2013 Mosby Inc. All rights reserved.
SDGs
Other Subjects
hyperpolarization activated cyclic nucleotide gated potassium channel 4; ion channel; unclassified drug; adolescent; article; clinical assessment; controlled study; disease course; female; follow up; gene mutation; heart rate; heart rate variability; human; long term care; major clinical study; male; mutational analysis; outcome assessment; parasympathetic tone; priority journal; sinus bradycardia
Publisher
Mosby Inc.
Type
journal article