Related Experiment Videos
["Left anterior hemiblock" or "extreme left axis deviation" in the ECG of children]
Insights
Extreme left-axis deviation in children is common, occurring in 212 of 3618 patients. Researchers suggest using "left-axis deviation" instead of "Left anterior Hemiblock" unless conduction system damage is confirmed.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Diagnostic Imaging
Context:
- Electrocardiograms (ECGs) are crucial for diagnosing pediatric cardiac conditions.
- Extreme left-axis deviation (eLAD) is a specific ECG finding in children.
- Understanding the prevalence and causes of eLAD is important for accurate diagnosis.
Purpose:
- To identify children with extreme left-axis deviation (eLAD) using strict criteria.
- To categorize children with eLAD based on cardiac status: no heart defects, congenital anomalies, or post-surgery.
- To differentiate between general eLAD and Left Anterior Hemiblock (LAH).
Summary:
- A 5-year study at Giessen University Children's Hospital identified 212 children with eLAD among 3618 ECGs.
- eLAD was observed in children without heart defects (73.8% with QRS vector -30 to -90 degrees), with congenital heart defects (often -60 to -90 degrees), and post-cardiac surgery.
- Specific conditions associated with eLAD included Down's Syndrome, complete A-V canals, Transposition of Great Arteries, and post-Tetralogy of Fallot repair.
Impact:
- The study suggests reserving "Left Anterior Hemiblock" for confirmed conduction system damage.
- Recommends using the broader term "left-axis deviation" when damage is uncertain, reflecting a likely anomaly rather than a complete block.
- This distinction aids in more precise clinical interpretation of pediatric ECG findings.
Abstract:
A comprehensive study involving the use of ECG's from children at the Giessen University Children's Hospital was conducted with the specific intent of identifying all children with an extreme left-axis deviation. This study showed that, in a time period of five years, 212 out of 3618 children examined electrocardiographically had an extreme left-axis deviation according to very strict criteria, their ECG-types could be divided into three groups: 1. without heart defects, 2. with congenital heart anomalies, 3. after surgery for congenital heart problems. Measurement of the QRS-complex in eighty children without heart defect showed that fifty-nine of the children (73.8%) had a vector -QRS between -30 degrees to -90 degrees. Ih the 88 children with congenital heart defects, and in 20 with an extreme left-axis deviation previous to surgery, an angle of -60 degrees to -90 degrees was found, most often in children with complete A-V canals of Down's Syndrome (as well as in children with transposition of the great arteries, univentricular heart or other complicated malformations of the heart). And finally, an extreme left axis deviation was very often found after surgery to correct Tetralogy of Fallot, ventricular defect, or endocardial cushion defect. Since an extreme left-axis deviation often occurs in children without heart defects, we would like to suggest that the term "Left anterior Hemiblock" be reserved for cases where there is certainty that damage to the conduction system has occurred. In all other cases, we prefer the term "left-axis deviation" as a more appropriate because an anomaly in the conduction system is more likely than a "block" i.e. an interruption of the conduction of electrical impulses through the heart muscle.