Frequency and timing of recurrent events in infants using home cardiorespiratory monitors.

Abstract

To determine the incidence, type, timing, and factors predictive of recurrent significant events in infants with home cardiorespiratory monitors. We reviewed data accumulated for 147 patients with an event-recorder type of monitor. The infants were allocated to one of four diagnostic categories: apparent life-threatening events (ALTE, n = 73), former premature infants with persistent apnea and bradycardia (n = 29), siblings of victims of sudden infant death syndrome (SIDS) (n = 24), and parental anxiety after a nonsignificant event (n = 21). Compliance with monitoring was excellent; the monitors were used on 94% of the prescribed days. Fifty-three (36%) of 147 infants had significant events; of those, 46 (87%) experienced their first event during the first month of monitoring, and 69% of the events occurred during that first month. The most prevalent event type was a bradycardic event. Among infants in the ALTE group, events during the initial investigation period predicted the likelihood of events at home; 2 of the 47 infants (4%) with negative results for an investigation and no events recorded in hospital had apnea, and 4 had a bradycardic event (9%). In contrast, when significant events were recorded in hospital, the events were likely to recur at home (69% and 35% of the infants had apnea or bradycardia, respectively; p < 0.001). Because most apnea, bradycardia, and recurrent clinical events began during the first month of monitoring, we emphasize the need for vigilant follow-up care of infants immediately after institution of home monitoring. Readmission for investigation is warranted in infants with severe or multiple recurrent events.