Heart rate variability in children and adolescents with incidentally found early repolarization pattern

Area of Science:

• Pediatric Cardiology
• Autonomic Nervous System Function
• Electrocardiography

Background:

• Early repolarization pattern (ERP) on ECG, once deemed benign, is now associated with fatal arrhythmias.
• The significance of ERP in pediatric populations is not well-established.
• This study examines the risk of premature death and arrhythmia in children with incidentally detected ERP.

Purpose of the Study:

• To investigate the association between incidentally detected early repolarization pattern (ERP) and adverse cardiac events in children.
• To evaluate electrocardiogram (ECG) and heart rate variability (HRV) parameters in children with ERP.
• To determine the clinical relevance of ERP in a pediatric cohort.

Main Methods:

• Cross-sectional study of healthy children aged 6-18 years with and without incidentally detected ERP.
• Utilized medical history, physical examination, 12-lead ECG, echocardiography, and 24-h Holter monitoring.
• Analyzed ECG parameters (QTc, JT, Tp-e) and time/frequency-domain HRV metrics (SDNN, LF/HF ratio).

Main Results:

• Children with ERP exhibited lower heart rates and increased JT dispersion.
• ERP group showed greater interventricular septal thickness and higher LF/HF ratios, indicating increased sympathetic activity.
• Inferolateral ERP was associated with higher heart rate and altered autonomic parameters during sleep.

Conclusions:

• Incidental ERP in children is not linked to arrhythmic events but correlates with heightened parasympathetic tone.
• ERP in pediatric patients may suggest an increased risk of autonomic imbalance, particularly with inferolateral localization.
• Further research is needed to clarify the long-term implications of ERP in children.