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Ambulatory monitoring in normal children
Insights
Ambulatory ECG monitoring in children revealed significant sinus arrhythmias and J-point variations. This study highlights challenges in pediatric ECG data acquisition and provides insights into normal pediatric cardiac electrical activity.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Clinical Electrophysiology
Background:
- Ambulatory ECG monitoring (AM) is crucial for assessing cardiac function.
- Pediatric cardiac assessments require specialized considerations due to physiological differences.
- Understanding normal variations in pediatric ECG is essential for accurate diagnosis.
Purpose of the Study:
- To characterize ambulatory ECG parameters in healthy children across different age groups.
- To identify common findings and challenges in pediatric AM.
- To establish reference values for pediatric cardiac electrical activity.
Main Methods:
- Conducted 24-hour ambulatory ECG monitoring on 90 healthy children (neonate, 1-year, 5-year age groups).
- Analyzed ECG data for frequency, variability, hourly patterns, arrhythmias, and J-point/T-wave changes.
- Documented technical issues affecting data quality, such as detached electrodes and artifacts.
Main Results:
- High rate (approx. 50%) of unusable ECG registrations due to technical issues.
- Observed high maximum frequencies, significant diurnal variations (feeding-related in neonates, circadian in older children).
- Prevalence of marked sinus arrhythmia (80%), rare isolated extrasystoles, and frequent J-point deviations (upward/downward deflections).
Conclusions:
- Pediatric ambulatory ECG monitoring presents significant technical challenges.
- Sinus arrhythmia is a common finding in healthy children.
- J-point variations and T-wave modifications are observed, requiring further investigation in pediatric populations.
Abstract:
An Ambulatory ECG monitoring (AM) was carried out over a 24 hr. period on 90 healthy children divided into 3 age groups (lst week of life, 1 year of age and 5 years of age). There was a high number (about 50%) of unusable registrations because of detached electrodes, broken leads, and artifacts. The AM on children is characterised by: a) high values of the maximum frequencies (mean maximum absolute frequency 178 at birth, 164 at one year, 154 at 5 years); b) a great difference between the maximums and minimums; c) hourly variations related, above all, to feedings in the new-born babies and of a circadian type in the 5 years old children; d) almost constant marked sinus arrhythmias (80%); extremely rare extrasystolia (7.5 atrial, 2.5 ventricular) and always isolated; e) presence of upward (27%) and downward deflection (10%) of the J point sometimes accompanied by modifications of the T wave (22%).