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Electrocardiograms in Healthy North American Children in the Digital Age

Saarel, E. V.; Granger, S.; Kaltman, J. R.; Minich, L. L.; Tristani-Firouzi, M.; Kim, J. J.; Ash, K.; Tsao, S. S.; Berul, C. I.; Stephenson, E. A.; Gamboa, D. G.; Trachtenberg, F.; Fischbach, P.; Vetter, V. L.; Czosek, R. J.; Johnson, T. R.; Salerno, J. C.; Cain, N. B.; Pass, R. H.; Zeltser, I.; Silver, E. S.; Kovach, J. R.; Alexander, M. E.

Circ Arrhythm Electrophysiol. 2018 Jun 23; 11(7):e005808


BACKGROUND: Interpretation of pediatric ECGs is limited by lack of accurate sex- and race-specific normal reference values obtained with modern technology for all ages. We sought to obtain contemporary digital ECG measurements in healthy children from North America, to evaluate the effects of sex and race, and to compare our results to commonly used published datasets. METHODS: Digital ECGs (12-lead) were retrospectively collected for children /=3 years (P/=12 years (P<0.05). The R wave amplitude in V6 was greater for boys compared with girls for age groups >/=12 years (P<0.001), for blacks compared with white or other race categories for age groups >/=3 years (P/=12 years (P<0.0001). CONCLUSIONS: In this large, diverse cohort of healthy children, most ECG intervals and amplitudes varied by sex and race. These differences have important implications for interpreting pediatric ECGs in the modern era when used for diagnosis or screening, including thresholds for left ventricular hypertrophy.

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