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Exercise-induced electrocardiographic changes after treadmill exercise testing in healthy children: A comprehensive

Elaheh Malakan Rad1, Mohsen Karimi1, Sara Momtazmanesh2

  • 1Department of pediatric cardiology, Children's Medical Center (Pediatric Center of Excellence), Tehran University of Medical Sciences, Affiliated to Tehran University of Medical Sciences, Tehran, Iran.

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Summary

This study found that treadmill exercise significantly alters electrocardiogram (ECG) parameters in healthy children, with diastolic time decreasing more than systolic time. Different heart rate correction formulas impact QT interval measurements, crucial for diagnosing conditions like long QT syndrome.

Keywords:
ElectrocardiogramJ point to end of T wave intervalJ to peak T intervalOnset of Q wave to the end of T wave intervalT peak to T end intervalexercise test

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Area of Science:

  • Pediatric Cardiology
  • Exercise Physiology
  • Electrocardiography

Background:

  • Treadmill exercise testing is vital for diagnosing pediatric heart conditions.
  • Comprehensive studies on exercise-induced electrocardiogram (ECG) changes in healthy children are limited.
  • Existing research often overlooks detailed atrial and ventricular depolarization/repolarization parameters.

Purpose of the Study:

  • To comprehensively evaluate exercise-induced ECG changes in healthy children.
  • To assess the impact of gender on these ECG parameters.
  • To compare the effects of four heart rate correction formulas on ventricular repolarization.

Main Methods:

  • Prospective study of 74 healthy children (April 2019-April 2020).
  • Inclusion criteria: normal ECG, echocardiogram, exercise test, and consent.
  • Measurement of 20 ECG parameters and calculation of 25 indices.

Main Results:

  • Exercise increased P, S, and T wave amplitudes.
  • Most ECG durations decreased post-exercise; T peak -T end /QT (Tp-e/QT) interval did not.
  • Ventricular repolarization parameters showed no significant gender differences; heart rate correction formulas yielded varying QTc, JTc, and Tp-e/QTc values.

Conclusions:

  • Diastolic time reduction exceeded systolic time reduction during exercise.
  • Heart rate correction formulas significantly influence QT and JT interval measurements, impacting long QT syndrome diagnosis.
  • Gender does not significantly affect ventricular repolarization in healthy children aged 5-14.