Paroxysmal vagal overactivity, apparent life-threatening event and sudden infant death

The possibility of reversible cardiac asystoly due to paroxysmal vagal over activity (VO) has been well studied, first in adults, then in children, and finally in breath-holding spells. Few studies deal with infants and the in cidence of VO among preterm, apparent life-threatening event (ALTE) and sud den infant death syndrome (SIDS). In this review, we summarize data acquire d during the past 20 years leading to the diagnosis of VO in infants. We de scribe the clinical aspects of VO in infants and young children such as Hol ter-ECG and oculocardiac reflex criteria. The familiar aspect of VO and its possible link with SIDS (a new risk factor?) are discussed. Finally, wheth er or not to treat infants with symptomatic VO is discussed. Copyright (C) 2000 S. Karger AG, Basel.