A. Cote et al., FREQUENCY AND TIMING OF RECURRENT EVENTS IN INFANTS USING HOME CARDIORESPIRATORY MONITORS, The Journal of pediatrics, 132(5), 1998, pp. 783-789
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.