Background The occurrence of transient bradycardia is a frequent and well-documented phenomenon in preterm infants. We have recently confirmed the presence of transient nonsinus bradyarrhythmias in very low birth weight (VLBW) infants. The most common type of nonsinus bradyarrhythmia was atrial in origin.
Objective The objective of the present study was to describe the P wave changes during the nonsinus atrial bradyarrhythmias.
Methods Cardiorespiratory waveforms including ECG from bedside monitors were captured on a networked computer and subsequently analyzed for nonsinus bradyarrhythmias. Nonsinus atrial bradyarrhythmias were further analyzed to determine the instantaneous heart rate (R-R interval), the P-R interval, the amplitude of the P wave, and the morphology and direction of deflection of the P waves. For each bradycardic event, these parameters were collected for a control period (representing baseline rate and rhythm), a sinus bradycardia period, and a nonsinus bradycardia period.
Results A total of 35 events were analyzed in 10 VLBW infants. In 27 events, there was a marked decrease in the amplitude of the P wave in comparison with baseline. In 14 of these events, the P-R interval decreased as the arrhythmia progressed.
Conclusion We conclude that significant changes in P wave amplitude and P-R intervals occur during transient bradyarrhythmias in VLBW infants. Further study to investigate these rhythm disturbances and treatment options is warranted.
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