BRADYCARDIA AND GASTROESOPHAGEAL REFLUX IN TERM AND PRETERM INFANTS -IS THERE ANY RELATION

Conflicting data are published regarding the influence of acid gastroe sophageal reflux on the heart rate. In this study, heart rate was moni tored simultaneously with esophageal pH in 50 infants with symptoms su ggestive of gastroesophageal reflux disease (frequent vomiting and reg urgitations). The data of 25 preterm infants (born at 28-366/7 weeks) were compared to those of 25 term infants (born after 37 weeks of gest ation). However, both groups were investigated at identical postconcep tional age of 47-49 weeks. Not one significant bradycardia (heart rate less than or equal to 80/min during greater than or equal to 10 s) wa s recorded, although 71 ''relative bradycardia episodes'' (heart rate less than or equal to 80/min during greater than or equal to 5 beats) were detected, none lasting for >5 s. Although the number of infants w ith relative bradycardia episodes did not differ between groups, the r elative bradycardia episodes occurred more frequently in some preterm infants (53 episodes in preterm infants vs. 18 in term babies). Acid g astroesophageal reflux episodes were observed in 46 infants (92%). Nei ther the number of reflux episodes nor their duration was different in both groups. Simultaneous relative bradycardia episodes and acid refl ux episodes were observed in three of 23 preterm and two of 23 term in fants (NS). It is concluded that in a population of preterm and term i nfants with symptoms suggestive of a moderate gastroesophageal reflux pathology, investigated at comparable postconceptional age, most reflu x episodes are not time-related to changes in heart rate.