Clinical determinants of electrocardiographic and spatial vectorcardiographic descriptors of ventricular repolarization in healthy children

Abstract

Background:: Although the association of repolarization alterations to the development of life-threatening ventricular arrhythmias has received considerable research attention, there is paucity of data regarding what may be considered as normal, especially in children. Methods: To define electrocardiographic (ECG) and vectorcardiographic (VCG) descriptors of ventricular repolarization in healthy school-age children, 12-lead digital ECGs were obtained from 646 children (348 males/298 females, mean age 8.54 ± 1.86 years). All QT intervals were measured manually using the digitally stored ECGs. Orthogonal X, Y, and Z leads were reconstructed from the standard 12-lead ECGs and the maximal amplitudes of the spatial QRS and T vectors were calculated, as well as the spatial QRS-T angle. Results: The mean heart rate was 95.3 ± 15.8 bpm and the QRS duration was 83.4 ± 9.3 ms. Mean QT interval was 334.1 ± 24.2 ms and the corrected QT interval was 436.5 ± 23.8 ms (Bazzet) and 404.3 ± 19.4 ms (Fridericia). Although the uncorrected maximum and mean QT intervals were significantly higher in boys (P values 0.011 and 0.009, respectively), there was no difference in the rate-corrected QT interval. The spatial QRS and T-vector amplitudes were 1512.0 ± 365.7 μV and 478.8 ± 149.3 μV, respectively. The spatial QRS-T angle was 14.1 ± 8.0 degrees. Although the mean QT interval showed significant increase with age (P = 0.014), all VCG parameters did not show significant variance with age. Conclusions:: A range of ECG and VCG descriptors of ventricular repolarization was determined in a large sample of healthy school-age children to provide a data basis of normal values for future reference. ©2011, Wiley Periodicals, Inc.