The Utilization of an Insertable Cardiac Monitor in a Child With Pallid Breath-Holding Spells.

BACKGROUND: Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia.

PATIENT DESCRIPTION: We describe an 18-month-old girl experiencing severe pallid breath-holding spells in whom repeated electrocardiographic, Holter, and electroencephalographic monitoring tests were all normal.

RESULTS: Using a subcutaneous insertable cardiac monitor, severe bradycardia was detected during one of this girl's episodes. This finding led to a pacemaker implantation. Subsequently, her breath-holding spells completely resolved.

CONCLUSION: This child illustrates the ability of the insertable cardiac monitor to help and diagnose arrhythmias in children with unresolved clinical findings. The ability to implant it with a minimal scar makes it ideal for uncooperative individuals with relative few and unexpected episodes that are hard to diagnose.