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16 February 2020 : Case report  USA

Asymptomatic Idiopathic Belhassen Ventricular Tachycardia in a Neonate Detected Using ‘Smart Sock’ Wearable Smartphone-Enabled Cardiac Monitoring

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease

Ming-Lon Young1ABDEFG*, Leslie Flores2B

DOI: 10.12659/AJCR.921092

Am J Case Rep 2020; 21:e921092

Abstract

BACKGROUND: Wearable smartphone-enabled cardiac monitoring devices can aid the diagnosis of asymptomatic tachycardia in neonates and infants. This report is of a rare case of left posterior fascicular ventricular tachycardia of Belhassen type detected in a neonate by ‘smart sock’ cardiac monitoring.

CASE REPORT: A premature baby boy at 37 weeks gestational age was discharged home after three days without complication, and was given ‘smart socks’ to wear. He was followed up daily for the management of hyperbilirubinemia, which was treated in the outpatient clinic with a phototherapy blanket. He was admitted to the emergency room (ER) at 6 days of age because his ‘smart socks’ identified a tachycardia of between 180–200 bpm. His parents reported no fever, cough, nasal congestion, or emesis. On examination in the ER, he was alert with no distress. An electrocardiogram (ECG) showed a sustained monomorphic and wide QRS tachycardia with a heart rate of 200 bpm, right bundle branch block (RBBB), and a superior axis that was compatible with a diagnosis of left posterior fascicular ventricular tachycardia of Belhassen type. The echocardiogram showed a structurally normal heart with normal cardiac function. His tachycardia spontaneously converted to normal sinus rhythm after four hours. He was discharged home three days later without further episodes of tachycardia. Cardiac monitoring using ‘smart socks’ continued at home, and no further arrhythmias were detected at one year of age.

CONCLUSIONS: The home use of smartphone-enabled technology to monitor the neonatal and infant cardiac heart rate can identify asymptomatic arrhythmias.

Keywords: Clinical Alarms, Infant, Newborn, Tachycardia, Ventricular, Bundle-Branch Block, Monitoring, Ambulatory, Smartphone, Wearable Electronic Devices

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923