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[Heart rate and heart rhythm in healthy infants and children]
G von Bernuth1, R Toussaint, C Mund
1Klinik für Kinderkardiologie der Medizinischen Fakultät, Rheinisch-Westfälische Technische Hochschule, Aachen.
Insights
This study analyzed cardiac rhythms in 141 children using 24-hour ambulatory electrocardiograms. Findings reveal common arrhythmias like sinus arrhythmias and supraventricular beats, establishing normal pediatric heart rate ranges.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Clinical Pediatrics
Context:
- Normal cardiac rhythm and rate variations in children are not well-defined.
- Ambulatory electrocardiographic (ECG) monitoring is crucial for assessing pediatric cardiac health.
- Understanding age-specific ECG patterns is essential for accurate diagnosis.
Purpose:
- To establish normative data for cardiac rate and rhythm in healthy infants, toddlers, and schoolchildren.
- To characterize common arrhythmias and electrophysiological findings in pediatric populations.
- To provide a basis for interpreting ambulatory ECGs in children.
Summary:
- 141 healthy children (infants, toddlers, schoolchildren) underwent 24-hour ambulatory ECG monitoring.
- Data on maximal/minimal heart rates, longest RR intervals, and prevalence of arrhythmias (sinus arrhythmias, escape beats, AV block, extrasystoles) were collected.
- Age-specific heart rate ranges and common rhythm variations were identified, including sinus arrhythmias mimicking SA block and frequent supraventricular escape rhythms.
Impact:
- Provides essential reference data for pediatric cardiologists and electrophysiologists.
- Aids in the accurate interpretation of ambulatory ECGs in children, distinguishing normal variations from pathology.
- Contributes to improved diagnosis and management of cardiac conditions in pediatric patients.
Abstract:
Cardiac rate and rhythm in 141 healthy infants, toddlers and schoolchildren during 24 hour ambulatory electrocardiographic monitoring are reported. Maximal and minimal heart rate (1/min) in infants 1 to 5 months of age were 204 +/- 17 and 105 +/- 13, in infants 6 to 12 months of age 187 +/- 19 and 101 +/- 15; in toddlers 177 +/- 17 and 66 +/- 10; in schoolchildren 158 +/- 24 and 54 +/- 6. A sizeable proportion of children of all age groups showed patterns of sinus arrhythmias indistinguishable from second degree sinuatrial block. Supraventricular escape beats and escape rhythms were frequent as well. The longest RR interval was 1.03 +/- 0.16 sec. in infants, 1.20 +/- 0.25 sec. in toddlers, and 1.35 +/- 0.15 sec., respectively, in schoolchildren. Two % of infants, 7% of toddlers, and 6% of schoolchildren had episodes of second degree atrioventricular block type I (Wenckebach) at rest. Supraventricular extrasystoles were found in 38%, 13% and 26%, respectively, and uniform ventricular extrasystoles in 18%, 20% and 16%, respectively, of infants, toddlers and schoolchildren. These data, together with similar information in the literature, can be taken as basis for the evaluation of ambulatory electrocardiograms in children.