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Normal values of signal-averaged electrocardiographic parameters and QT dispersion in infants and children

Published online by Cambridge University Press:  19 August 2008

Emmanuelle Vialle ,
Rim Albalkhi ,
Marc Zimmerman  and
Béat Friedli
Emmanuelle Vialle
Affiliation:
Hôpital cantonal universitaire, Unit of Pediatric Cardiology, Geneve, Switzerland
Rim Albalkhi
Affiliation:
Hôpital cantonal universitaire, Unit of Pediatric Cardiology, Geneve, Switzerland
Marc Zimmerman
Affiliation:
Hôpital cantonal universitaire, Unit of Pediatric Cardiology, Geneve, Switzerland
Béat Friedli*
Affiliation:
Cardiology Division, Geneve, Switzerland
*
Béat Friedli, M.D., Hôpital cantonal universitaire, Unité de Cardiologie Pédiatrique, 1211 GENEVE 14, Switzerland. Tel: 41 22 382 45 80; Fax: 41 22 382 46 24 ; E-mail: [email protected]
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Abstract

Ventricular late potentials, and dispersion of the QT interval, are markers for risk of ventricular arrhythmias. Normal values for these parameters are well established in adults, but may not apply for children. This study has investigated the age dependency of signal averaged electrocardiographic parameters and QT dispersion in 111 normal children aged from 5 days to 16 years. The results indicate that parameters change with age: duration of filtered QRS and low amplitude (< 40 μV) terminal signal increase with age, especially in the younger patients. Filtered QRS is 88.9 ± 7.87 ms in infants, and increases to 108.7 ± 8.51 in teenagers (p<0.001). Low amplitude terminal signals are 17.0 ± 3.44 ms in infants, and 24.5 ± 5.64 ms in teenagers (p< 0.001). Root mean square of the last 40 ms decreases with age, but remains stable after the age of 10 years (122.4 ± 33.30 μV in infants, 60.9 ± 31.27 in teenagers,p<0.001). QT dispersion, on the other hand, does not change significantly with age. The mean value for the whole group is 36 ± 13.7 ms. A weak but significant correlation exists between QT dispersion and filtered QRS. Thus, age must be taken into consideration when interpreting signal-averaged electrocardiograms, but not when measuring QT dispersion.

Keywords

QT dispersionsignal-averaged electrocardiogramarrhythmias in the young
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 6 , November 1999 , pp. 556 - 561
Copyright
Copyright © Cambridge University Press 1999

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References

1Breithardt, G, Borggrefe, M. Pathophysiological mechanisms and clinical significance of ventricular late potentials. Eur Heart J 1986;7:364–385.CrossRefGoogle ScholarPubMed
2Simpson, MB. Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction. Circulation 1981;64:235–242.CrossRefGoogle Scholar
3Yunus, A, Gillis, AM, Duff, HJ, Wyse, DG, Mitchell, LB. Increased precordial QTc dispersion predicts ventricular fibrillation during acute myocardial infarction. Am J Cardiol 1996;78:706.CrossRefGoogle ScholarPubMed
4Goldner, B, Brandspiegel, HZ, Horwitz, L, Jadonath, R, Cohen, TJ. Utility of QT dispersion combined with the signal-averaged electrocardiogram in detecting patients susceptible to ventricular tachyarrhythmia. Am J Cardiol 1995;76:1192–1193.CrossRefGoogle ScholarPubMed
5DJ, Pinsky, RR, Sciacca, JS, Steinberg. QT dispersion as a marker of risk in patients awaiting heart transplantation. J Am Coll Cardiol 1997;29:1976–1584.Google Scholar
6Zimmermann, M, Friedli, B, Adamec, R, Oberhänsli, I. Frequency of ventricular late potentials and fractionated right ventricular electrograms after operative repair of tetralogy of Fallot. Am J Cardiol 1987;59:448–453.CrossRefGoogle ScholarPubMed
7Zimmermann, M, Friedli, B, Adamec, R, Oberhänsli, I. Ventricular late potentials and induced ventricular arrhythmias after surgical repair of tetralogy of Fallot. Am J Cardiol 1991;67:873–878.CrossRefGoogle ScholarPubMed
8Janousek, J, Paul, T, Bartakova, H. Role of late potentials in identifying patients at risk for ventricular tachycardia after surgical correction of congenital heart disease. Am J Cardiol 1995;75:146–150.CrossRefGoogle ScholarPubMed
9Breithardt, G, Cain, ME, El-Sherif, N, Flowers, N, Hombach, VJanse, M, Simson, MB, Steinbeck, G. Standards for analysis of ventricular late potentials using high resolution or signal-averaged electrocardiography. Eur Heart J 1991;12:473–480.CrossRefGoogle ScholarPubMed
10Hayabuchi, Y, Matsuoka, S, Kubo, M, Akita, H, Kuroda, Y. Agerelated criteria for signal-averaged electrocardiographic late potentials in children. Ped Cardiol 1994;15:107–111.CrossRefGoogle ScholarPubMed
11Fallah-Najmabadi, H, Dahdah, NS, Palcko, M, Mehta, SK. Normal values and methodologic recommendations for signal-averaged electrocardiography in children and adolescents. Am J Cardiol 1996;77:408–412.CrossRefGoogle ScholarPubMed
12Jimbo, O, Zhang, J, Seki, T, Ogawa, S. Criteria for evaluating abnormal signal-averaged electrocardiogram in children classified by age, body surface area and height. Jpn Circ J 1996;60:228–238CrossRefGoogle ScholarPubMed
13Zimmermann, M, Adamec, R, Simonin, P, Fromer, M, Richez, J. Noninvasive detection of ventricular late potentials: direct comparison of 7 different high-gain recording systems. Am J Noninvas Cardiol 1992;6:154–167.CrossRefGoogle Scholar
14Shankara, Reddy BR, Christenson, DW, Rowlandson, GI. High-resolution ECG on a standard ECG cart. J Electrocardiol 1988;21(supp):S74–S79.CrossRefGoogle Scholar
15Sagie, A, Larson, MG, Goldberg, RJBengtson, JR, Levy, D. An improved method for adjusting the QT interval for heart rate (the Framingham heart study). Am J Cardiol 1992;70:797–801.CrossRefGoogle Scholar
16Daliento, L, Caneve, F, Turrini, P, Buja, G, Nava, A, Milanesi, O, Stellin, G, Rizzoli, G. Clinical significance of high-frequency, low-amplitude electrocardiographic signals and QT dispersion in patients operated on for tetralogy of Fallot. J Am Coll Cardiol 1995;76:408–411.CrossRefGoogle ScholarPubMed
17Gatzoulis, MA, Till, JA, Redington, AN. Depolarization-repolarization inhomogenecity after repair of tetralogy of Fallot. Circulation 1997; 95, 401–404.CrossRefGoogle Scholar
18Vaksmann, G, Elkonen, M, Duhamel, A, Godart, F. Signal-averaged electrocardiography in healthy children : influence of age, body size and gender. PACE 1996; 19:1629–1634.CrossRefGoogle ScholarPubMed
19Davis, AM, McCrindle, BW, Hamilton, RM, Moore-Coleman, P, Gow, RM. Normal values for the childhood signal-averaged ECG. PACE 1996;19:793–801.CrossRefGoogle ScholarPubMed
20Hill, JA, Friedman, PL. Measurement of QT interval and QT dispersion. Lancet 1997;349:894–895.CrossRefGoogle ScholarPubMed
21Shah, MJ, Wiesand, TS, Rhodes, LA, Berul, CI, Vetter, VL. QT and JT dispersion in children with long QT syndrome. J Cardiovasc Electroph 1997;8:642–648.CrossRefGoogle ScholarPubMed
22Garson, A. How to measure the QT interval - what is normal ? Am J Cardiol 1993;72:14B–16B.CrossRefGoogle Scholar
23Martin, AB, Perry, JC, Robinson, JL, Zareba, W, Moss, AJ, Garson, A Jr. Calculation of QTc duration and variability in the presence of sinus arrhythmia. Am J Cardiol 1995;75:950–952.CrossRefGoogle ScholarPubMed
24Faber, T.S., Jeron, A., Würth, A., Just, H, Zehender, M. Do we need correction for heart rate when assessing QT dispersion for risk stratification? Eur Heart J 1997; 18, Abstract Supplement: 199.Google Scholar
25Malik, M, Camm, AJ. Mystery of QTc interval dispersion. Am J Cardiol 1997;79:785–78Google ScholarPubMed