Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-18T23:12:59.315Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence of arrhythmias and conduction disturbances in large population-based samples of children

Published online by Cambridge University Press:  20 January 2005

Koichiro Niwa ,
Naomi Warita ,
Yuko Sunami ,
Akimitsu Shimura ,
Shigeru Tateno  and
Katsuo Sugita
Koichiro Niwa
Affiliation:
Department of Pediatrics, Chiba Cardiovascular Center, Division of Medicine, Faculty of Education, Chiba University and Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
Naomi Warita
Affiliation:
Department of Pediatrics, Chiba Cardiovascular Center, Division of Medicine, Faculty of Education, Chiba University and Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
Yuko Sunami
Affiliation:
Department of Pediatrics, Chiba Cardiovascular Center, Division of Medicine, Faculty of Education, Chiba University and Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
Akimitsu Shimura
Affiliation:
Department of Pediatrics, Chiba Cardiovascular Center, Division of Medicine, Faculty of Education, Chiba University and Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
Shigeru Tateno
Affiliation:
Department of Pediatrics, Chiba Cardiovascular Center, Division of Medicine, Faculty of Education, Chiba University and Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
Katsuo Sugita
Affiliation:
Department of Pediatrics, Chiba Cardiovascular Center, Division of Medicine, Faculty of Education, Chiba University and Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of our study is to provide data on the prevalence of disturbances of rhythm in the general population of children. Accurate estimates of true prevalence of such disturbances of rhythm from large samples are mandatory if we are to interpret properly electrocardiographic abnormalities. We analysed prevalence of disturbances of rhythm in a population of 152,322, comprised of 71,855 elementary school students, 36,692 males and 35,163 females, aged from 5 to 6 years, and 80,467 students of junior high school, 41,842 males and 38,625 females, aged from 12 to 13 years. We analysed the prevalence of premature atrial and ventricular contractions, first, second and third degree atrioventricular block, incomplete and complete right bundle branch block, Wolff-Parkinson-White syndrome, and prolongation of the QT interval. The prevalence of disturbances of rhythm in total rose with age, being found in 1.25% of elementary school students and 2.32% of junior high school students, and was higher in males than females, at 2.00% as opposed to 1.38%, both values being statistically significant at a level of less than 0.0001. Prevalences of all types of rhythmic disturbances were higher in junior high school students than elementary school students (p < 0.0001). Premature atrial and ventricular contractions and prolongation of the QT interval were higher in female than male students, at percentages of 0.089, 0.497, and 0.02 for males, and 0.123, 0.534 and 0.027 in females (p < 0.0001). In contrast, incomplete and complete right bundle branch blocks were higher in males than females, at 0.983% and 0.083% in males versus 0.410% and 0.161% in females (p < 0.0001). Disturbances of rhythm increased with age, and conduction disturbances were higher in male students than female, although premature atrial and ventricular contractions and prolongation of the QT interval were more frequent in female. These data may be useful for future comparative studies of disturbance of rhythm in children.

Keywords

Wolff-Parkinson-Whitepremature atrial contractionpremature ventricular contractionatrioventricular blockright bundle branch blockQT prolongation
Type
Original Article
Information
Cardiology in the Young , Volume 14 , Issue 1 , February 2004 , pp. 68 - 74
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hiss RG, Lamb LE. Electrocardiographic findings in 122,043 individuals. Circulation 1962; 25: 947–961.Google Scholar
De Bacquer D, De Backer G, Kornitzer M. Prevalences of ECG findings in large population based samples of men and women. Heart 2000; 84: 625–633.Google Scholar
Blackburn H. Electrocardiographic classification for population comparisons. The Minnesota code. J Electrocardiol 1969; 2: 5–9.Google Scholar
Blackburn H, Keys A, Simonson E, Rautaharju P, Punsar S. The electrocardiogram in population studies. A classification system. Circulation 1960; 21: 1160–1175.Google Scholar
De Bacquer D, De Backer G, Kornitzer M, Blackburn H. Prognostic value of ECG findings for total, cardiovascular disease, and coronary heart disease death in men and women. Heart 1998; 80: 570–577.Google Scholar
Ostrander LD, Brandt RL, Kjelsberg MO, Epstein FH. Electrocardiographic findings among the adult population of a total natural community. Tecumseh, Michigan. Circulation 1965; 31: 888–898.Google Scholar
Tsuda J, Niimura I, Matsuo M. Statistics of arrhythmias in school age. Health guidance of heart disease in childhood (in Japanese). Nihon-Ijishinpo 1982; 3035; 43–48.Google Scholar
Tasaki H, Hamasaki Y, Ichimaru T. Mass screening for heart disease of school children in Saga city: 7-year follow-up study. Jpn Circ J 1987; 51: 1415–1420.Google Scholar
Ookuni M, Harada K, Kitada M, et al. School cardiac screening test. Guideline for selection of second step screening. Pediatr Cardiol Cardiac Surg (in Japanese). 1996; 12: 725–730.Google Scholar
Schwarz PJ, Moss AJ, Vincent GM, Crampton RS. Diagnostic criteria for the long QT syndrome. An update. Circulation 1993; 88: 782–784.Google Scholar
Yoshinaga M, Tomari T, Aihoshi S, et al. Exponential correction of QT interval to minimize the effect of the heart rate in children. Jpn Circ J 1993; 57: 102–108.Google Scholar
Nagashima M, Matsushima M, Ogawa A, et al. Cardiac arrhythmias in healthy children revealed by 24-hour ambulatory ECG monitoring. Pediatr Cardiol 1987; 8: 103–108.Google Scholar
Thrainsdottir IS, Hardarson T, Thorgeirsson G, Sigvaldason H, Sigfusson N. The epidemiology of right bundle branch and its association with cardiovascular morbidity – the Reykjavik Study. Euro Heart J 1993; 14: 1590–1596.Google Scholar
Bikkina M, Larson MG, Levy D. Prognostic implications of asymptomatic ventricular arrhythmias: the Framingham heart study. Ann Intern Med 1992; 117: 990–996.Google Scholar
Fisher FD, Tyroler HA. Relationship between premature contractions on routine electrocardiogram and subsequent sudden death from coronary heart disease. Circulation 1973; 47: 712–719.Google Scholar
Young D, Eisenberg R, Fish B, Fisher JD. Wenchebach atrioventricular block (Mobitz type I) in children and adolescents. Am J Cardiol 1977; 40: 393–399.Google Scholar
Mymin D, Mathewson FAL, Tate RB, Manfreda J. The natural history of primary first-degree atrioventricular heart block. New Engl J Med 1986; 315: 1183–1187.Google Scholar
Ross BA, Pinsky WW, Driscoll DJ. Complete atrioventricular block. In: Gillette PC, Garson A (eds). . Philadelphia, W.B. Saunders, 1990, pp 306–316.
Ashley EA, Raxwal VK, Froelicher VF. The prevalence and prognostic significance of electrocardiographic abnormalities. Curr Probl Cardiol 2000; 25: 1–72.Google Scholar
Rotman M, Triebwasser JH. A clinical and follow-up study of right and left bundle branch block. Circulation 1975; 51: 477–484.Google Scholar
Schneider JF, Thomas HE, Kreger BE, McNamara PM, Sorlie P, Kannel WB. Newly acquired right branch block: the Framingham study. Ann Intern Med 1980; 92: 37–44.Google Scholar
Munger TM, Packer DL, Hammill SC, et al. A population study of the natural history of Wolff-Parkinson-White syndrome in Olmstedt Country, Minnesota, 1953–1989. Circulation 1993; 87: 866–873.Google Scholar
Perry JC, Garson A Jr. Supraventricular tachycardia due to Wolff-Parkinson-White syndrome in children: early disappearance and late recurrence. J Am Coll Cardiol 1990; 16: 1215–1220.Google Scholar
Vignati G, Balla E, Mauri L, Lunati M, Figini A. Clinical and electrophysiologic evolution of the Wolff-Parkinson-White syndrome in children: impact on approaches to management. Cardiol Young 2000; 10: 367–375.Google Scholar
Sano S, Komori S, Amano T, et al. Prevalence of ventricular preexcitation in Japanese school children. Heart 1998; 79: 374–378.Google Scholar
Gillette PC. Concealed anomalous cardiac conduction pathways: a frequent cause of supraventricular tachycardia. Am J Cardiol 1977; 40: 848–852.Google Scholar
Klein GJ, Hackel DB, Gallagher JJ. Anatomic substrate of impaired antegrade conduction over an accessory atrioventriucular pathway in the Wolff-Parkinson-White syndrome. Circulation 1980; 61: 1249–1256.Google Scholar
Schwartz PJ. The long QT syndrome. Curr Probl cardiol 1997; 22: 297–357.Google Scholar
Fukushige T, Yoshinaga M, Shinago A, et al. Effect of age and overweight on the QT interval and the prevalence of long QT syndrome in children. Am J Cardiol 2002; 89: 395–398.Google Scholar
Aihoshi S, Yoshinaga M, Nakamura M, Oku S, Haraguchi T, Nishibatake M. Screening for QT prolongation using a new exponential formula. Jpn Circ J 1995; 59: 185–189.Google Scholar
Eberle T, Hessling G, Ulmer HE, Brockmeier K. Prediction of normal QT intervals in children. J Electrocardiol 1998; 31: 121–125.Google Scholar
Pearl W. Effects of gender, age, and heart rate on QT intervals in children. Pediatr Cardiol 1996; 17: 135–136.Google Scholar