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Normal ranges of heart rate variability during infancy and childhood
1Department of Pediatric Cardiology, Klinikum der R.W.T.H. Aachen, Aachen, Germany.
Insights
This study establishes normal heart rate variability (HRV) ranges for children, revealing autonomic nervous system maturation with age. These findings aid in assessing pediatric cardiac autonomic function.
Area of Science:
- Pediatric Cardiology
- Autonomic Nervous System Function
- Noninvasive Cardiac Assessment
Background:
- Heart rate variability (HRV) serves as a key noninvasive indicator of cardiac neural activity.
- Understanding normative HRV values across pediatric age groups is crucial for clinical interpretation.
Purpose of the Study:
- To determine age-specific normal ranges for various heart rate variability indices in infants and children.
- To investigate the relationship between HRV parameters, age, and mean RR interval in a pediatric cohort.
Main Methods:
- Evaluated 210 healthy infants and children aged 3 days to 14 years.
- Measured HRV using time-domain (SDNN, SDNN-i, SDANN-i, r-MSSD, pNN50) and frequency-domain (VLF, LF, HF, LF/HF ratio) indices.
- Analyzed correlations between HRV indices, mean RR interval, and age.
Main Results:
- All HRV indices showed a significant positive correlation with the mean RR interval, except for the LF/HF ratio.
- A positive power correlation was observed between all HRV parameters and increasing age.
- Multiple correlation analysis confirmed age and mean RR interval as independent predictors of HRV.
Conclusions:
- The study confirms progressive maturation of the autonomic nervous system throughout childhood, reflected in HRV.
- Established pediatric HRV ranges provide a valuable reference for evaluating cardiac autonomic tone in health and disease.
- These normative data can inform the assessment of therapeutic interventions impacting cardiac autonomic function in children.
Abstract:
Heart rate variability is a noninvasive index of the neural activity of the heart. The present study examined heart rate variability indices in 210 infants and children aged 3 days to 14 years to obtain normal ranges for all age classes. Heart rate variability was measured by calculating mean RR interval over the length of the analysis, mean RR interval during quiet sleep, 5 time-domain (SDNN, SDNN-i, SDANN-i, r-MSSD, pNN50), and 4 frequency-domain (VLF, LF, HF, LF/HF ratio) indices. Our data show a significant positive correlation between all indices and the mean RR interval over the length of the analysis, except for the LF/HF ratio for which the correlation was binomial. A positive power correlation was also found between all parameters and age. The multiple correlation analysis confirmed the independent effect of age and mean RR interval on the heart rate variability. These data in a healthy pediatric population confirm a progressive maturation of the autonomic nervous system during childhood and may be utilized to examine the effects of underlying disease processes or therapeutic interventions on cardiac autonomic tone during infancy and childhood.