University of Washington Department of Pediatrics and Seattle Children's Hospital Seattle, Washington, USA.
Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia, Italy.
J Clin Sleep Med. 2021 Dec 1;17(12):2393-2398. doi: 10.5664/jcsm.9440.
Monitoring electrocardiogram is an integral component of pediatric polysomnography (PSG). There are limited data regarding arrhythmia and conduction disturbances in the pediatric population undergoing a PSG. In this work we present abnormal electrocardiogram findings during PSG in our sleep center.
A retrospective chart review from children who underwent PSG read by a single sleep medicine physician in the last year was carried out. Findings in children without cardiac disease and with first or second degree atrioventricular block were compared to those from children with premature ventricular contractions.
A total of 1,235 PSGs were included. Twenty-four children (9 girls and 15 boys) aged 2-17 years (median 9 years) were identified with arrhythmias or conduction disturbances (1.9%). Nineteen out of 24 of these children (79.2%) had obstructive apnea-hypopnea index > 1 event/h; this frequency was not significantly different from that found in the whole group of 1,235 children. No statistically significant difference was found between children with atrioventricular block or premature ventricular contractions. Seven out of 9 children with atrioventricular block and 7 out of 10 with premature ventricular contractions had obstructive apnea-hypopnea index > 1 event/h, while 8 children with atrioventricular block out of 9 and 4 out of 10 with premature ventricular contractions were males (Fisher's exact test = .04). None of the children were found to have a structural or conduction abnormality when referred to cardiology.
Our study supports that electrocardiogram abnormalities are rare in PSGs of children and not associated with cardiac disease or sleep disorders but appear more commonly in males.
Amin A, Mogavero MP, Ferri R, DelRosso LM. Incidental electrocardiogram abnormalities in children undergoing polysomnography. . 2021;17(12):2393-2398.
心电图监测是小儿多导睡眠图（PSG）的一个组成部分。在接受 PSG 的儿科人群中，心律失常和传导障碍的数据有限。在这项工作中，我们展示了我们睡眠中心进行 PSG 时的异常心电图发现。
对过去一年中由一位睡眠医学医生阅读的接受 PSG 的儿童进行了回顾性图表审查。将无心脏病且存在一度或二度房室传导阻滞的儿童与存在室性期前收缩的儿童的发现进行了比较。
共纳入 1235 例 PSG。确定了 24 名年龄在 2-17 岁（中位数 9 岁）的患有心律失常或传导障碍的儿童（1.9%）。这 24 名儿童中有 19 名（79.2%）存在阻塞性睡眠呼吸暂停低通气指数>1 事件/小时；与 1235 名儿童的整体组相比，这一频率没有显著差异。房室传导阻滞或室性期前收缩的儿童之间无统计学差异。7 名房室传导阻滞儿童和 10 名室性期前收缩儿童中的 7 名阻塞性睡眠呼吸暂停低通气指数>1 事件/小时，而 9 名房室传导阻滞儿童中的 8 名和 10 名室性期前收缩儿童中的 4 名是男性（Fisher 确切检验=0.04）。当转介至心脏病学时，没有发现任何儿童存在结构或传导异常。
我们的研究支持心电图异常在儿童 PSG 中很少见，且与心脏病或睡眠障碍无关，但在男性中更为常见。
Amin A, Mogavero MP, Ferri R, DelRosso LM. 在接受多导睡眠图检查的儿童中偶然出现心电图异常。. 2021;17(12):2393-2398.
