FREQUENCY AND TIMING OF RECURRENT EVENTS IN INFANTS USING HOME CARDIORESPIRATORY MONITORS

Objective: To determine the incidence, type, timing, and factors predi ctive of recurrent significant events in infants with home cardiorespi ratory monitors.Study design: We reviewed data accumulated for 147 pat ients with an event-recorder type of monitor. The infants were allocat ed to one of four diagnostic categories: apparent life-threatening eve nts (ALTE, n = 73), former premature infants with persistent apnea and bradycardia (n = 29), siblings of victims of sudden infant death synd rome (SIDS) (n = 24), and parental anxiety after a nonsignificant even t (n = 21). Results: Compliance with monitoring was excellent; the mon itors were used on 94% of the prescribed days. Fifty-three (36%) of 14 7 infants had significant events; of those, 46 (87%) experienced their first event during the first month of monitoring, and 69% of the even ts occurred during that first month. The most prevalent event type was a bradycardic event. Among infants in the ALTE group, events during t he initial investigation period predicted the likelihood of events at home; 2 of the 47 infants (4%) with negative results for an investigat ion and no events recorded in hospital had apnea, and 4 had a bradycar dic 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). Conclusion: Because most apnea, bradycardia, and recurrent clinical events began d uring the first month of monitoring, we emphasize the need for vigilan t follow-up care of infants immediately after institution of home moni toring. Readmission for investigation is warranted in infants with sev ere or multiple recurrent events.