Normal electrocardiographic patterns in school-aged children: Data from a sports cardiology screening program

Area of Science:

• Pediatric Cardiology
• Sports Medicine
• Electrocardiography

Background:

• Distinguishing normal developmental changes from cardiac pathology in pediatric ECGs is challenging.
• Pre-participation screening (PPS) in young athletes requires accurate interpretation of ECGs.
• Current ECG interpretation guidelines may not fully account for age- and sex-specific variations.

Purpose of the Study:

• To establish age- and sex-specific ECG reference patterns in healthy young athletes.
• To enhance the accuracy of pediatric ECG interpretation during sports pre-participation screening.
• To optimize referral practices by reducing false positives.

Main Methods:

• Evaluation of 243 healthy participants (aged 5-16 years) at a cardio sports clinic.
• Analysis of ECG parameters including heart rate, PR interval, QTc, and QRS durations.
• Comparison of ECG findings between different age groups and sexes.

Main Results:

• No significant sex-based differences in age or weight were observed.
• Females (10-16 years) showed higher heart rates (p=0.020); males had longer PR intervals (p=0.011).
• T-wave inversion patterns varied by age group; prolonged QTc and Wolff-Parkinson-White (WPW) patterns were infrequent.

Conclusions:

• Age and sex are crucial considerations for interpreting pediatric ECGs, especially in sports screening.
• Sex-specific reference values for heart rate and PR interval may improve clinical practice for older children.
• Accurate ECG interpretation aids in appropriate referral decisions for young athletes.