Effects of iron replacement on electrocardiogram parameters in breath-holding spells patients with iron deficiency

This study aimed to examine electrocardiogram parameters in patients with breath-holding spells accompanied by iron deficiency before iron treatment and after three months of iron supplementation therapy. A total of 195 children were included in the study, consisting of 95 patients with breath-holding spells and 100 age- and gender-matched controls. Patients were evaluated for iron deficiency at admission. Iron deficiency was associated with 48 patients who had breath-holding spells, while it was not associated with 47 of them. When comparing the ECG parameters of patients with breath-holding spells (BHS) and the control group, the QRS and QT intervals were found to be significantly longer in patients with BHS (p<0.05). However, no statistically significant differences were observed between the two groups in terms of PHR, Pmax, Pd, QTd, QTc, QTcd, Tp-e, Tp-e/QT, and Tp-e/QTc (p>0.05). In BHS patients with iron deficiency, QRS, QT, and QTc durations were observed to shorten after iron supplementation therapy, with statistically significant reductions (p=0.036, p=0.011, p=0.008, respectively). Additionally, BHS did not recur in 45.23% of patients who received iron supplementation therapy. Our study found that QRS, QT, and QTc durations shortened following iron supplementation in pediatric patients with BHS and iron deficiency anemia. This highlights the beneficial effects of iron on ventricular depolarization and repolarization parameters. Therefore, ECG parameter evaluation should always be considered in the management of patients with breath-holding spells, particularly those with iron deficiency.