Prone back electrocardiogram in healthy children: comparison with routine supine electrocardiogram

Area of Science:

• Pediatric Cardiology
• Diagnostic Electrocardiography

Background:

• Oxygen support in the prone position is crucial for pediatric acute respiratory distress syndrome.
• Obtaining a standard supine electrocardiogram (ECG) can be challenging in children requiring prone positioning.
• The study investigates the feasibility of a prone back ECG in healthy children.

Purpose of the Study:

• To evaluate the effectiveness of a 12-lead electrocardiogram performed on the back of children in the prone position.
• To identify any significant electrocardiogram changes in healthy children when the ECG leads are placed on the back.

Main Methods:

• Fifty healthy children aged 3–7 years participated.
• Standard supine ECGs were recorded first.
• A modified 12-lead ECG was performed with precordial leads placed on the patient's back in the prone position (prone V1–V6).

Main Results:

• Most wave amplitudes (P, Q, R, S, T) were significantly smaller in prone back leads (V1–V5) compared to supine leads (p < 0.001).
• Similar mean T wave amplitudes were observed between prone V3 and supine V3.
• Similar mean Q wave amplitudes were noted between prone V5 and supine V5.
• Average P, Q, S, and T wave amplitudes were comparable between prone V6 and supine V6.

Conclusions:

• A back electrocardiogram in the prone position is a practical and useful method.
• This technique provides valuable diagnostic information for clinicians.
• It offers a viable alternative for ECG acquisition when supine positioning is not feasible.