{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:03:23Z","timestamp":1788228203986,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,12,22]],"date-time":"2017-12-22T00:00:00Z","timestamp":1513900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study assessed cardiac performance and iron in subjects aged 12\u201336\u00a0months with breath\u2010holding spells (<jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We consecutively recruited 40 subjects (55% male) experiencing <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>s from the general paediatric outpatients department at the Children's Hospital, Ain Shams University, Egypt, from 2015 to 2016. The 20 matched comparisons were mainly healthy siblings. The workup included iron levels and electrocardiograms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The age at the onset of <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>s was 5\u201324\u00a0months with a median monthly frequency of 13. Almost two\u2010thirds of the patients had cyanotic spells, and one\u2010third had pallid spells, lasting 25\u201390\u00a0seconds. Lower serum iron levels and higher <jats:styled-content style=\"fixed-case\">QT<\/jats:styled-content> dispersion and T\u2010wave dispersion were recorded in patients than the comparison group, and 4.8% had dysrhythmia and bradycardia. We observed higher durations of bradycardia during attacks and higher occurrences of dysrhythmia during cyanotic spells, which were more frequent in patients with prolonged or frequent <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study of patients aged 12\u201313\u00a0months supported the theory of autonomic dysfunction in <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>s. The <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content> findings, especially in patients with prolonged or frequent spells, need to be studied further to evaluate the risk of life\u2010threatening events. Iron deficiency may play a role in autonomic dysfunction in patients with <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14177","type":"journal-article","created":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T07:22:40Z","timestamp":1512544960000},"page":"653-657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Paediatric breath\u2010holding spells are associated with autonomic dysfunction and iron deficiency may play a role"],"prefix":"10.1111","volume":"107","author":[{"given":"H","family":"Tomoum","sequence":"first","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Habeeb","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Elagouza","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Mobarez","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307389701200408"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.2.265"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.5.859"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2005.tb02080.x"},{"key":"e_1_2_10_6_1","first-page":"385","article-title":"T\u2010Peak to T\u2010End abnormality in pediatric patients with syncope","volume":"22","author":"Amoozgar H","year":"2012","journal-title":"Iran J Pediatr"},{"key":"e_1_2_10_7_1","first-page":"303","article-title":"Hypochromic anemia in children with breath\u2010holding spells","volume":"54","author":"Zubcevic S","year":"2000","journal-title":"Med Arh J"},{"key":"e_1_2_10_8_1","first-page":"687","article-title":"Cardiac Repolarization Changes in the children with breath\u2010holding spells","volume":"23","author":"Amoozgar H","year":"2013","journal-title":"Iran J Pediatr"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pec.0000179258.85397.27"},{"key":"e_1_2_10_10_1","volume-title":"Iron deficiency anemia: assessment, prevention and control: a guide for programme managers. 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