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Study on ECG in the Adolescent.

Hung-Chi Lue1, Mei-Hwan Wu2, Jou-Kou Wang2

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Summary

This study establishes normal electrocardiogram (ECG) standards for male and female adolescents, revealing significant sex-based differences emerging by age 6-9 and becoming more pronounced through puberty. These findings provide crucial reference values for adolescent cardiac health assessments.

Keywords:
Children and adolescentsMale and femaleNormal ECG valuesPuberty

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Area of Science:

  • Cardiology
  • Pediatric Medicine
  • Biomedical Engineering

Background:

  • Established normal electrocardiogram (ECG) values exist for neonates, infants, and children.
  • Normal ECG standards for adolescents, however, are not well-defined, creating a gap in pediatric cardiac assessment.
  • Adolescence is a critical period of physiological change, including puberty, which can impact cardiac parameters.

Purpose of the Study:

  • To establish comprehensive normal electrocardiogram (ECG) standards for male and female adolescents.
  • To analyze age- and sex-specific variations in 69 ECG parameters within the adolescent population.
  • To identify the age at which sex-specific ECG differences emerge during adolescence.

Main Methods:

  • Recruited 898 healthy school children and adolescents, categorized into 6-9, 9-13, and 13-18 year age groups.
  • Recorded a 12-lead conventional ECG using a Fukuda Denshi FCP-4301 machine at standardized settings (10 mm/mV, 25 mm/s).
  • Analyzed 69 ECG parameters, calculating mean, standard deviation, percentiles, confidence intervals, and sex differences, with data undergoing analog-to-digital conversion at 500 Hz.

Main Results:

  • Established normal values for 69 ECG parameters, including heart rate, intervals, durations, axes, wave amplitudes, R/S ratios, and ventricular activation times, stratified by age and sex.
  • Observed statistically significant sex differences in 49 (71.0%) of the analyzed ECG parameters.
  • Noted that ECG sex differences first appeared in the 6-9 year age group, with the majority emerging in the 9-13 and 13-18 year groups, correlating with pubertal development.

Conclusions:

  • Successfully established normal male and female ECG standards for 69 parameters in adolescents.
  • Demonstrated that sex-specific ECG differences begin as early as ages 6-9 and become more prevalent during mid-to-late adolescence.
  • These findings underscore the importance of age- and sex-specific ECG reference values for accurate adolescent cardiac health evaluation, reflecting pubertal influences.