New normal limits for the paediatric electrocardiogram

• Published in: European heart journal Vol. 22; no. 8; pp. 702 - 711
• Main Authors: Rijnbeek, P.R, Witsenburg, M, Schrama, E, Hess, J, Kors, J.A
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2001
• Subjects: Adolescent; Age Factors; Biological and medical sciences; Child; Child, Preschool; computer; Diagnosis, Computer-Assisted; Electrocardiography; Electrocardiography - instrumentation; Electrocardiography - methods; Electrocardiography - standards; Electrocardiography - trends; Electrocardiography. Vectocardiography; Electrodiagnosis. Electric activity recording; Female; Heart Rate; Humans; Infant; Infant, Newborn; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Netherlands; normal limits; paediatrics; Reference Values; Sex Characteristics; Signal Processing, Computer-Assisted; Netherlands; Human; Electrodiagnosis; Computer program; Electrocardiography; Exploration; Limit; Technique; Normal; Child
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.2000.2399

Aims Previous studies that determined the normal limits for the paediatric ECG had their imperfections: ECGs were recorded at a relatively low sampling rate, ECG measurements were conducted manually, or normal limits were presented for only a limited set of parameters. The aim of this study was to establish an up-to-date and complete set of clinically relevant normal limits for the paediatric ECG. Methods and Results ECGs from 1912 healthy Dutch children (age 11 days to 16 years) were recorded at a sampling rate of 1200Hz. The digitally stored ECGs were analysed using a well-validated ECG computer program. The normal limits of all clinically relevant ECG measurements were determined for nine age groups. Clinically significant differences were shown to exist, compared with previously established normal limits. Sex differences could be demonstrated for QRS duration and several amplitude measurements. Conclusions These new normal limits differ substantially from those commonly used and suggest that diagnostic criteria for the paediatric ECG should be adjusted.