Skip to main content
Top
Published in: Pediatric Cardiology 5/2018

01-06-2018 | Original Article

Study on ECG in the Adolescent

Authors: Hung-Chi Lue, Mei-Hwan Wu, Jou-Kou Wang, Min-Tai Lin, Chun-Wei Lu, Shuenn-Nan Chiu, Chun-An Chen, En-Ting Wu, Ching-Chia Wang, Chun-Min Fu, Wei-Chien Tseng, Wei-Hsuan Chang, Meng-Chang Lee

Published in: Pediatric Cardiology | Issue 5/2018

Login to get access

Abstract

Normal ECG values in newborns, infants, and children have been collected and published. ECG in the adolescent, however, remains, to be collected and studied. The present study was designed and carried out to establish the normal ECG standards in male and female adolescents. A total of 898 school children and adolescents screened and examined as healthy were divided by age and sex into 6–9, 9–13, and 13–18 years age-groups. A 12 lead conventional ECG was recorded in 10 mm/mV and 25 mm/s, utilizing an automated Fukuda Denshi FCP-4301, MS-DOS/IBM-AT ECG machine. Lead V3R was not taken. Analog-to-digital conversion was performed by Fukuda signal acquisition module at a sampling rate of 500 Hz. The data on 69 ECG parameters were analyzed for the mean, standard deviation, 2nd to 98th percentiles, 95% confidence intervals, and sex difference. Normal values on 69 ECG parameters, sex-specific heart rate, P-QRS-T interval, duration, axis, wave amplitude, and calculated R/S amplitude ratio and ventricular activation time by age-group and sex were established. Male and female difference was noted in 49 (71.0%) parameters, of which 3 (6.1%) began in 6–9 years age-group, 30 (61.2%) began in 9–13 years age-group, and 16 (32.7%) in 13–18 years age-group. No sex difference occurred in 20 (29.0%) parameters. Normal male and female ECG standards on 69 ECG parameters in the adolescent were established. ECG sex difference began to appear the earliest at ages 6–9 years, and it occurred mostly at ages 9–13 years and 13–18 years, reflecting the anatomical and physiological consequences of puberty.
Literature
1.
go back to reference Ziegler RF (1951) Electrocardiographic studies in normal infants and children. Charles C Thomas Publisher, Springfield Ziegler RF (1951) Electrocardiographic studies in normal infants and children. Charles C Thomas Publisher, Springfield
2.
go back to reference Lue HC (1962) An electrocardiographic study of normal newborn infants. Acta Paed Sin 3(4):129–142 Lue HC (1962) An electrocardiographic study of normal newborn infants. Acta Paed Sin 3(4):129–142
3.
go back to reference Davignon A, Rautaharju P, Boisseff E et al (1979/80) Normal ECG standards for infants and children. Ped Cardiol 1:123–131 Davignon A, Rautaharju P, Boisseff E et al (1979/80) Normal ECG standards for infants and children. Ped Cardiol 1:123–131
4.
go back to reference Rijinbeek PR, Witsenburg M, Schrama E, Hess J, Kors JA (2001) New normal limits for the pediatric electrocardiogram. European Heart J 22:702–711CrossRef Rijinbeek PR, Witsenburg M, Schrama E, Hess J, Kors JA (2001) New normal limits for the pediatric electrocardiogram. European Heart J 22:702–711CrossRef
5.
go back to reference Lue HC, Lai YC, Wu MH, Wang JK, Massachusetts USA et al (2006) ECG in the child and adolescent. Normal standards and percentile charts. Blackwell Futura, OxfordCrossRef Lue HC, Lai YC, Wu MH, Wang JK, Massachusetts USA et al (2006) ECG in the child and adolescent. Normal standards and percentile charts. Blackwell Futura, OxfordCrossRef
6.
go back to reference Semizel E, Ozturk B, Cil E, Ediz B (2008) The effects of age and gender on the electrocardiograms in children. Cardiol Young 18:26–40CrossRefPubMed Semizel E, Ozturk B, Cil E, Ediz B (2008) The effects of age and gender on the electrocardiograms in children. Cardiol Young 18:26–40CrossRefPubMed
7.
go back to reference Miklashevich IM, Shkol’nikova MA, Kalinin LA et al (2009) Normal values of temporal parameters of ECG in children according to results of clinico-epidemiological study ECG-screening of children and adolescents in Russian federation. Cardiologia 49(10):47–54 Miklashevich IM, Shkol’nikova MA, Kalinin LA et al (2009) Normal values of temporal parameters of ECG in children according to results of clinico-epidemiological study ECG-screening of children and adolescents in Russian federation. Cardiologia 49(10):47–54
8.
go back to reference Bailey JJ, Berson AS, Garson A Jr et al (1990) Recommendations for standardization and specifications in automated electrocardiography: bandwidth and digital signal processing. A report for health professionals by an Ad Hoc Writing Group of the Committee on Electrocardiography and Cardiac Electrophysiology of the Council on Clinical Cardiology. Am Heart Assoc Circ 81(2):730–739 Bailey JJ, Berson AS, Garson A Jr et al (1990) Recommendations for standardization and specifications in automated electrocardiography: bandwidth and digital signal processing. A report for health professionals by an Ad Hoc Writing Group of the Committee on Electrocardiography and Cardiac Electrophysiology of the Council on Clinical Cardiology. Am Heart Assoc Circ 81(2):730–739
9.
go back to reference Macfarlane PW, Coleman EN, Devine B et al (1990) A new 12-lead pediatric ECG interpretation program. J Electrocardiol 23:76–81CrossRefPubMed Macfarlane PW, Coleman EN, Devine B et al (1990) A new 12-lead pediatric ECG interpretation program. J Electrocardiol 23:76–81CrossRefPubMed
10.
go back to reference Rautaharju PM, Park L, Rautaharju FS et al (1998) A standardized procedure for locating and documenting ECG chest electrode positions. Consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol 31(1):17–29CrossRefPubMed Rautaharju PM, Park L, Rautaharju FS et al (1998) A standardized procedure for locating and documenting ECG chest electrode positions. Consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol 31(1):17–29CrossRefPubMed
11.
12.
go back to reference Surawicz B, Parikh SR (2002) Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age. J Am Coll Cardiol 40:1870–1876CrossRefPubMed Surawicz B, Parikh SR (2002) Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age. J Am Coll Cardiol 40:1870–1876CrossRefPubMed
13.
go back to reference Bidoggia H, Maciel JP, Capalozza N et al (2000) Sex differences on the electrocardiographic pattern of cardiac repolarization: possible role of testosterone. Am Heart J 140:678–683CrossRefPubMed Bidoggia H, Maciel JP, Capalozza N et al (2000) Sex differences on the electrocardiographic pattern of cardiac repolarization: possible role of testosterone. Am Heart J 140:678–683CrossRefPubMed
14.
go back to reference Vicente J, Johannesen L, Galeotti L, Strauss DG (2014) Mechanisms of sex and age differences in ventricular repolarization in humans. Am Heart J 168:749–756CrossRefPubMed Vicente J, Johannesen L, Galeotti L, Strauss DG (2014) Mechanisms of sex and age differences in ventricular repolarization in humans. Am Heart J 168:749–756CrossRefPubMed
15.
go back to reference Eisenberg P, Ribeiro F, Meja M. Simonson E, Blackburn H Jr, Puchner TC (1960) Sex differences in the electrocardiogram. Circulation 22:598–601CrossRef Eisenberg P, Ribeiro F, Meja M. Simonson E, Blackburn H Jr, Puchner TC (1960) Sex differences in the electrocardiogram. Circulation 22:598–601CrossRef
16.
go back to reference Rao PS, Thapar MK, Harp RJ (1984) Racial variations in electrocardiograms and vectorcardiograms between black and white children and their genesis. J Electrocardiol 17:239–252CrossRefPubMed Rao PS, Thapar MK, Harp RJ (1984) Racial variations in electrocardiograms and vectorcardiograms between black and white children and their genesis. J Electrocardiol 17:239–252CrossRefPubMed
17.
go back to reference Dickinson DF (2005) The normal ECG in childhood and adolescence. Heart 90:1626–1630CrossRef Dickinson DF (2005) The normal ECG in childhood and adolescence. Heart 90:1626–1630CrossRef
18.
go back to reference Kaplowitz PB, Oberfield SE (1999) Reexamination of the age limit for defining when puberty is precocious in girls in the United States: implications for evaluation and treatment. Drug and Therapeutics and Executive Committees of the Lawson Wilkins Pediatric Endocrine Society. Pediatrics 104(4 Pt 1):936–941CrossRefPubMed Kaplowitz PB, Oberfield SE (1999) Reexamination of the age limit for defining when puberty is precocious in girls in the United States: implications for evaluation and treatment. Drug and Therapeutics and Executive Committees of the Lawson Wilkins Pediatric Endocrine Society. Pediatrics 104(4 Pt 1):936–941CrossRefPubMed
19.
go back to reference Buck Louis GM, Gray LE, Marcus M et al (2008) Environmental factors and puberty timing: expert panel research needs. Pediatrics 121(Suppl 3):S192–S207CrossRefPubMed Buck Louis GM, Gray LE, Marcus M et al (2008) Environmental factors and puberty timing: expert panel research needs. Pediatrics 121(Suppl 3):S192–S207CrossRefPubMed
20.
go back to reference Mouritsen A, Aksglaede L, Sørensen K et al (2010) Hypothesis: exposure to endocrine-disrupting chemicals may interfere with timing of puberty. Int J Androl 33(2):346–359CrossRefPubMed Mouritsen A, Aksglaede L, Sørensen K et al (2010) Hypothesis: exposure to endocrine-disrupting chemicals may interfere with timing of puberty. Int J Androl 33(2):346–359CrossRefPubMed
21.
go back to reference Storstein L, Bjornstad H, Hals O et al (1991) Electrocardiographic findings according to sex in athletes and controls. Cardiology 79:227–236CrossRefPubMed Storstein L, Bjornstad H, Hals O et al (1991) Electrocardiographic findings according to sex in athletes and controls. Cardiology 79:227–236CrossRefPubMed
22.
go back to reference Amundsen P (1959) The diagnostic value of conventional radiological examination of the heart in adults. Norwegian monographs on medical science. University Press, Oslo Amundsen P (1959) The diagnostic value of conventional radiological examination of the heart in adults. Norwegian monographs on medical science. University Press, Oslo
23.
go back to reference Larsen JA, Kadish AH (1998) Effects of gender on cardiac arrhythmias. J Cardiovasc Electrophysiol 9:655–664CrossRefPubMed Larsen JA, Kadish AH (1998) Effects of gender on cardiac arrhythmias. J Cardiovasc Electrophysiol 9:655–664CrossRefPubMed
24.
go back to reference Macfarlane PW, McLaughlin SC, Devine B, Yang TF (1994) Effects of age, sex, and race on ECG interval measurements. J Electrocardiol 27:14–19CrossRefPubMed Macfarlane PW, McLaughlin SC, Devine B, Yang TF (1994) Effects of age, sex, and race on ECG interval measurements. J Electrocardiol 27:14–19CrossRefPubMed
25.
go back to reference Rautaharju PM, Zhou SH, Wong S et al (1992) Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol 8:690–695PubMed Rautaharju PM, Zhou SH, Wong S et al (1992) Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol 8:690–695PubMed
26.
go back to reference Merri M, Benhorin J, Alberti M et al (1989) Electrocardiographic quantitation of ventricular repolarization. Circulation 80:1301–1308CrossRefPubMed Merri M, Benhorin J, Alberti M et al (1989) Electrocardiographic quantitation of ventricular repolarization. Circulation 80:1301–1308CrossRefPubMed
Metadata
Title
Study on ECG in the Adolescent
Authors
Hung-Chi Lue
Mei-Hwan Wu
Jou-Kou Wang
Min-Tai Lin
Chun-Wei Lu
Shuenn-Nan Chiu
Chun-An Chen
En-Ting Wu
Ching-Chia Wang
Chun-Min Fu
Wei-Chien Tseng
Wei-Hsuan Chang
Meng-Chang Lee
Publication date
01-06-2018
Publisher
Springer US
Published in
Pediatric Cardiology / Issue 5/2018
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-018-1841-8

Other articles of this Issue 5/2018

Pediatric Cardiology 5/2018 Go to the issue