Asymptomatic idiopathic belhassen ventricular tachycardia in a neonate detected using ‘smart sock’ wearable smartphone-enabled cardiac monitoring

Abstract

Objective: Rare disease Background: Wearable smartphone-enabled cardiac monitoring devices can aid the diagnosis of asymptomatic tachycar-dia 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 complica-tion, and was given ‘smart socks’ to wear. He was followed up daily for the management of hyperbilirubine-mia, 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 tachycar-dia. 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.