Infant Bradycardia

[Dayna__0]

  i gave birth to quads.  all came home on a & b monitors.  3 off now but 1 is still on.  they were born at 28 1/2 wks.  came home having events of bradycardia.  now she all of the sudden right around christmas she has had approx. 4 or more episodes at night.  she is usually sound asleep.  last night she had approx. 8 all ranging from 4 beeps - 2 beeps in length.  my husband & i are getting very concerned.  her pediatrician upped her caffeine level from 1cc to 2cc's.   insistant this would work, but obviously it hasn't.  we haven't been happy with our dr. anyways. they took 3 1/2 weeks to get back to us on the results of he monitor download, and that was after we called them.  what could be causing these episodes all the sudden and what should we do about them.  i believe the dr's in the nicu said she had a small heart murmur and then it went away while she was in the hospital. please help i am desperate.....
  thank you,
  a worried mom
  colleen m

[CCF CARDIO MD APS]

Dear Colleen,
The prematurity alone can be the cause of these episodes, as a matter of fact
it is often not the heart that is the problem in premies when it comes to bradycardia.
It is very important that extrinsic stimuli are investigated that might be causing
the heart to become bradycardic (for instance reflux of stomach acid and more importantly
apneic episodes where the child stops breathing are potential causes of premies' bradycardia.)
Keep in mind however, that a certain degree of bradycardia is expected in premature infants, and
you need to be educated by your physicians as to what is acceptable and what you should call them about
in the middle of the night.  3+weeks seems like an awful long time to wait to hear about results, so next
time don't wait for a report, just call the doctor's office with your concerns and expect him or her to
get back to you in a reasonable period of time (like a day at the most.)  
If your not happy with any physician, you should either seek a second opinion, or at least discuss with
the physician that you are not at all happy with the care your child is getting, it is your right to go to
any doctor you want (of course, it is always best in this day and age to inquire with your insurance company
as to what will or will not be reimbursed.
I hope you find this information useful. Information provided in the heart forum is for general
purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to
write back with additional questions. Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call
1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that
can be used to select the physician best suited to address your cardiac problem.