ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1663243
This article is part of the Research TopicAdvancing Our Understanding of the Cardiac Conduction System to Prevent ArrhythmiasView all 5 articles
The λ pattern on Time-RR Interval Scatter Plot of Neonatal Ambulatory ECG: A Marker of Transient bradycardia
Provisionally accepted
- 1Electrocardiogram diagnostic department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
- 2Maternal and Child Health Hospital of Hubei Province, Wuhan, China
- 3Neonatology Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
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Neonatal bradycardia often triggers transient escape rhythms that challenge clinical diagnosis, with current methods lacking dynamic biomarkers for risk stratification.To validate the λ pattern, a heart rate dynamic signature on time-RR interval scatter plot, for distinguishing escape rhythms from transient sinus bradycardia and predicting recovery timelines in neonates.Retrospective analysis of 36 neonates ( ≤ 28 days) with 24h electrocardiogram (ECG) monitoring. Holter data identified λ patterns (abrupt ≥20% RR prolongation and >3 s gradual recovery). Reverseengineering ECG validated rhythm origins. Survival models assessed λ burden-prognosis correlations.487 λ patterns (15.5±3.2 / neonate) were detected: 80.3% escape rhythms, 19.7% sinus bradycardia. High λ burden (≥21/24h) predicted delayed recovery versus low burden (≤10/24h) (HR=4.22 (95% CI: 1.98-9.01), p<0.0001). All cases resolved spontaneously within 6 months.The λ pattern shows promise as a noninvasive biomarker for stratifying neonatal bradycardia and shows potential to guide recovery
Keywords: aECG, Bradycardia, neonate, t-RR scatter plot, Escape rhythm
Received: 10 Jul 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Li, Wei, Zhu, Zheng and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tingting Yu, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
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