Significance of isolated bradycardia detected by home monitoring.

OBJECTIVE

To determine the cause of isolated bradycardia during home cardiorespiratory monitoring.

SETTING

A tertiary care hospital.

STUDY DESIGN

A retrospective review of the charts of 8 patients with severe isolated bradycardia on their home monitoring reports. All subjects underwent polysomnography including a pH probe.

RESULTS

Monitor reports showed a characteristic pattern of long (30 to 60 seconds) periods of bradycardia, sometimes with asystole, associated with irregular respiratory efforts. All patients had severe gastroesophageal reflux, with a pH <4 for 63% +/- 22% (mean +/- SD) of recording time. No patient had other abnormalities to explain the bradycardia. Bradycardia resolved after successful treatment of reflux.

CONCLUSION

A pattern of isolated bradycardia associated with irregular respiratory efforts on home monitoring is highly suggestive of gastroesophageal reflux and should prompt further evaluation and treatment.