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T wave changes in the right precordial leads in seven- and eight-year-old children during a Valsalva manoeuvre
Insights
The Valsalva maneuver significantly increases positive T waves in the V1 lead of healthy children
Area of Science:
- Pediatric Cardiology
- Electrocardiography
- Physiology
Background:
- The T wave in the right precordial leads (V1-V3) can vary in healthy children.
- The influence of physiological maneuvers on T wave morphology in pediatric electrocardiograms (ECGs) requires further elucidation.
Purpose of the Study:
- To investigate the effect of the Valsalva maneuver on T wave positivity in the V1 lead of healthy children.
- To compare T wave morphology during relaxation versus the Valsalva maneuver in pediatric ECGs.
Main Methods:
- Electrocardiograms (ECGs) were recorded from 106 eight-year-old and 90 seven-year-old healthy children.
- Recordings were performed during both a relaxed state and a Valsalva maneuver.
- T wave polarity in right precordial leads (V1, V2, V4) was analyzed.
Main Results:
- In the relaxed state, only 3 children in each age group had a positive T wave in lead V1.
- During the Valsalva maneuver, 90/106 eight-year-olds and 55/90 seven-year-olds exhibited a positive T wave in lead V1.
- This conversion to a positive T V1 during the Valsalva maneuver was highly statistically significant (p < 0.001) in both sexes and age groups.
- Minor increases in T wave positivity were also observed in leads V2 and V4.
Conclusions:
- The Valsalva maneuver significantly induces a positive T wave in lead V1 in healthy children.
- This finding suggests that T wave positivity in V1 during the Valsalva maneuver is a normal physiological response in pediatric populations.
- Understanding these physiological changes is crucial for accurate interpretation of pediatric ECGs.
Abstract:
The T waves in the right precordial leads were analyzed in 106 eight-year-old and 90 seven-year-old unselected healthy children. Recordings during relaxation were compared with those obtained during a Valsalva manoeuvre. In the relaxed state only three children in each age group showed a positive T wave in lead V1, while during the Valsalva manoeuvre 90 of the 106 eight-year-old and 55 of the 90 seven-year-old children converted to a positive T V1. The difference is highly significant in both age groups and both sexes (p much less than 0.001). Minor changes towards more positive T V2 and T V4 were also found.