Rhythmological Findings in Pediatric Patients with Anorexia Nervosa: A Retrospective Data Analysis

Background: Anorexia nervosa (AN) is a serious psychiatric disorder with significant mortality, particularly among adolescents. Cardiovascular complications, such as bradycardia and QT interval abnormalities, are commonly described in this population. This study retrospectively analyzed 12-channel ECG findings in pediatric AN patients treated at our University Hospital to assess potential electrophysiological risks.

Methods: ECG data from 199 consecutive pediatric patients diagnosed with AN between July 2014 and May 2023 were reviewed. The analysis focused on heart rate, QTc interval, and arrhythmias, comparing initial and follow-up ECGs with those from a control group of 34 healthy adolescents.

Results: Bradycardia was prevalent among AN patients. There were significantly more cases of bradycardia in the patient group compared with the control group (68/195 vs. 5/34, p = 0.02). A subset of patients exhibited prolonged QTc intervals, particularly those with severe malnutrition. Arrhythmias, including both supraventricular and ventricular ectopic beats, were more frequent in the AN group. Follow-up data showed improvements in ECG parameters after weight restoration: for each 1-point increase in BMI, the resting pulse rate increased by an average of 4 beats per minute (p < 0.01).

Conclusion: This study highlights the critical need for regular electrophysiological monitoring in adolescents with AN. The observed QTc prolongations and arrhythmias underscore the potential cardiovascular risks, especially in malnourished patients. Importantly, weight normalization leads to the resolution of bradycardia and a return to normal heart rates, emphasizing the vital role of nutritional rehabilitation in reducing cardiovascular complications in this vulnerable population. Tailored interventions and ongoing assessments are essential for optimal management of these risks.

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Artikel online veröffentlicht:
11. Februar 2025