Evaluation of pediatric bradycardia: A single center experience

Abstract

Background: Heart rate is an integral part of the clinical assessment of the children with acute illness and is commonly used in pediatric early warning scores. Objective: The aim of this study was to assess our current practice for evaluation and management of bradycardia in children. Patients and methods: The study was conducted in Pediatric Arrhythmia Clinic, Neonatal Intensive Care Unit and Pediatric Intensive Care Unit from March 2020 to August 2021. 61 Neonates and children aged from 1 day to 18 years presenting with bradycardia were included in this study. Predeath bradycardia was excluded. Full medical history, physical examination, basic investigations, 12 leads ECG and echocardiography were performed to all patients. Thyroid function tests, 24 hours Holter monitoring, and stress ECG were done if indicated. Results: 61 patients were included in the study. Heart rate ranged from 44 to 94 beat/minute with mean 69.44 beat/minute, the most common form of presentation was abnormal echocardiography. Hypocalcemia was present in 85.2% of patients. 70.5% of patients had sinus bradycardia, 13% had complete heart block (CHB),10% of patients had long QTc Syndrome with sinus bradycardia, 3.3% had 1st and 2nd degree heart block, 1.6% had ECG changes of ALCAPA with sinus bradycardia and 1.6% had ventricular ectopic. Conclusion: It could be concluded that bradycardia in children needs accurate assessment to rule out the need of acute intervention and to decrease the risk of life-threatening conditions.