The value of QT interval in differentiating vasovagal syncope from epilepsy in children
Xin Wang1,2, Shuo Wang3, Haihui Xiao1,4
1Department of Pediatric Cardiovasology, Children's Medical Center , The Second Xiangya Hospital, Central South University, No.139 Renmin Middle Road, Hunan, 410011, Changsha, China.
Insights
This study found that specific QT interval measurements can help differentiate vasovagal syncope (VVS) from epilepsy in children. These ECG findings offer valuable insights for diagnosing transient loss of consciousness in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Neurology
- Clinical Electrophysiology
Background:
- Vasovagal syncope (VVS) and epilepsy are common causes of transient loss of consciousness in children.
- Distinguishing between VVS and epilepsy can be challenging due to overlapping symptoms.
- The QT interval's role in differentiating these conditions in pediatric populations requires further investigation.
Purpose of the Study:
- To evaluate the diagnostic value of the QT interval in differentiating VVS from epilepsy in children.
- To compare QT interval parameters between children with VVS, epilepsy, and healthy controls.
Main Methods:
- A cohort of 113 children with unexplained transient loss of consciousness was studied.
- Participants included 56 children with VVS, 57 with epilepsy, and 60 healthy controls.
- Basal 12-lead electrocardiogram (ECG) QT intervals (QTmax, QTmin, QTd, QTcmax, QTcmin, QTcd) were measured and analyzed.
Main Results:
- Children with VVS showed significantly longer QTcmax, QTcmin, and QTcd compared to controls (P < 0.05).
- Epilepsy group exhibited significantly shorter QTmax and QTmin than controls (P < 0.05).
- Compared to epilepsy, VVS group had significantly longer QTcmax, QTcmin, and QTcd (P < 0.05).
Conclusions:
- QTcmax, QTcmin, and QTcd measurements demonstrate potential utility in differentiating VVS from epilepsy in children.
- Specific QT interval thresholds may aid in the diagnosis of pediatric syncope and seizures.
Background:
Both vasovagal syncope (VVS) and epilepsy present with transient loss of consciousness and are often difficult to identify. Hence this study aimed to explore the value of QT interval in the differentiation of VVS and epilepsy in children.
Methods:
One hundred thirteen children with unexplained transient loss of consciousness were selected. 56 children with VVS (VVS group), including 37 males and 19 females, the average age is 9.88 ± 2.55 years old. 57 children with epilepsy (epilepsy group), including 36 males and 21 females, the average age is 8.96 ± 2.67 years old. At the same time, the 60 healthy individuals (control group) were examined according to age and sex. The QT interval of 12-lead electrocardiogram in a basal state of three groups was measured and statistically analyzed by SPSS 24.0 software.
Results:
Compared with the control group, (1) QTcmax, QTcmin and QTcd were significantly longer in VVS group (P < 0.05), QTmax and QTmin were significantly shorter in VVS group (P < 0.05), and there were no significant differences in QTd between the two groups (P > 0.05). (2) The QTmax and QTmin were significantly shorter in epilepsy group (P < 0.05), and there were no significant differences in QTd, QTcmax, QTcmin, QTcd between the two groups (P > 0.05). Compared with the epilepsy group, The QTcmax, QTcmin, QTcd were significantly longer in VVS group (P < 0.05), and there were no significant differences in QTd, QTmax, QTmin between the two groups (P > 0.05). When QTcmax > 479.84 ms, QTcmin > 398.90 ms and QTcd > 53.56 ms, the sensitivity and specificity of diagnosing VVS were 62.5% and 77.19%, 82.14% and 50.88%, 82.14% and 38.60% respectively.
Conclusion:
QTcmax, QTcmin and QTcd have certain value in differentiating VVS from epilepsy in children.
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