Age-related Criteria for Signal-averaged Electrocardiographic Late Potentials in Children

Overview

Journal Pediatr Cardiol

Specialties Cardiology & Vascular Diseases
Pediatrics

Date 1994 May 1

PMID 8047490

Citations 2

Authors

Y Hayabuchi

S Matsuoka

M Kubo

H Akita

Y Kuroda

Affiliations

Soon will be listed here.

Abstract

This study examined the age-related criteria of signal-averaged electrocardiographic (SA-ECG) parameters in children. SA-ECGs were obtained in 82 healthy volunteers in six groups depending on age (group 1: 1 day to < 1 month; group 2: 1 month to < 1 year; group 3: 1 to < 6 years; group 4: 6 to < 12 years; group 5: 12 to < 20 years; group 6: 20 to < 40 years). To examine the effect of heart rate on the parameters of SA-ECG, right atrial pacings were performed in 4 children with a ventricular septal defect aged 1-7 years. The root mean square voltage (RMS) was high; and the filtered QRS (f-QRS) duration and the duration of the low amplitude signal (LAS) were low during childhood, especially in infants (group 2), compared with those in adults. Late duration (LD) had no significant difference among age groups. The criteria for ventricular late potential were as follows: RMS < 25 microV, LAS > 35 ms, f-QRS duration > 110 ms, and LD > 35 ms for those age 1 day to < 1 month; RMS < 40 microV, LAS > 30 ms, f-QRS duration > 100 ms, and LD > 35 ms for those age 1 month to < 1 year; RMS < 20 microV, LAS > 40 ms, f-QRS duration > 130 ms, and LD > 35 ms for those age 1 to < 20 years; and RMS < 15 microV, LAS > 45 ms, f-QRS duration > 135 ms, and LD > 35 ms for those age 20 to < 40 years. RMS and LAS correlated with f-QRS duration (r = -0.78 and 0.76, respectively; p < 0.05), suggesting that these parameters are associated with the thickness of the ventricular muscle and the ventricular conduction time. Right atrial pacing had no effect on the measured SA-ECG parameters. The age-related differences in SA-ECG parameters might be due to age-related differences in the thickness of the ventricular muscle and the ventricular conduction time but are not due to differences in the heart rate. The age difference of each parameter on SA-ECG should be considered for ventricular late potentials.

Citing Articles

Signal-averaged electrocardiogram may be a beneficial prognostic procedure in the postoperative follow-up tetralogy of fallot patients to determine the risk of ventricular arrhythmias.

Eker Omeroglu R, Olgar S, Nisli K Pediatr Cardiol. 2007; 28(3):208-12.

PMID: 17486395 DOI: 10.1007/s00246-006-1157-y.

Signal-averaged electrocardiography in normal newborn infants.

Bennhagen R, Sornmo L, Pahlm O, Pesonen E Pediatr Cardiol. 2004; 25(5):451-8.

PMID: 15085305 DOI: 10.1007/s00246-003-0539-7.

References

SPACH M, Miller 3rd W, Dolber P, Kootsey J, SOMMER J, Mosher Jr C . The functional role of structural complexities in the propagation of depolarization in the atrium of the dog. Cardiac conduction disturbances due to discontinuities of effective axial resistivity. Circ Res. 1982; 50(2):175-91. DOI: 10.1161/01.res.50.2.175. View

Raineri A, Traina M, Lombardo R, Rotolo A . Relation between late potentials and echocardiographically determined left ventricular mass in healthy subjects. Am J Cardiol. 1991; 67(5):425-7. DOI: 10.1016/0002-9149(91)90054-o. View

SPACH M, Kootsey J . The nature of electrical propagation in cardiac muscle. Am J Physiol. 1983; 244(1):H3-22. DOI: 10.1152/ajpheart.1983.244.1.H3. View

Hoyt R, Cohen M, Saffitz J . Distribution and three-dimensional structure of intercellular junctions in canine myocardium. Circ Res. 1989; 64(3):563-74. DOI: 10.1161/01.res.64.3.563. View

Ohnishi Y, Inoue T, Fukuzaki H . Value of the signal-averaged electrocardiogram as a predictor of sudden death in myocardial infarction and dilated cardiomyopathy. Jpn Circ J. 1990; 54(2):127-36. DOI: 10.1253/jcj.54.127. View

Freedman R, Gillis A, Keren A, Mason J . Signal-averaged electrocardiographic late potentials in patients with ventricular fibrillation or ventricular tachycardia: correlation with clinical arrhythmia and electrophysiologic study. Am J Cardiol. 1985; 55(11):1350-3. DOI: 10.1016/0002-9149(85)90502-8. View

Pollak S, Kertes P, Bredlau C, Walter P . Influence of left ventricular function on signal averaged late potentials in patients with coronary artery disease with and without ventricular tachycardia. Am Heart J. 1985; 110(4):747-52. DOI: 10.1016/0002-8703(85)90452-1. View

St John Sutton M, Marier D, Oldershaw P, Sacchetti R, Gibson D . Effect of age related changes in chamber size, wall thickness, and heart rate on left ventricular function in normal children. Br Heart J. 1982; 48(4):342-51. PMC: 481258. DOI: 10.1136/hrt.48.4.342. View

Buckingham T, Thessen C, Stevens L, Redd R, KENNEDY H . Effect of conduction defects on the signal-averaged electrocardiographic determination of late potentials. Am J Cardiol. 1988; 61(15):1265-71. DOI: 10.1016/0002-9149(88)91167-8. View

10.

Zimmermann M, Adamec R, SIMONIN P, Richez J . Prognostic significance of ventricular late potentials in coronary artery disease. Am Heart J. 1985; 109(4):725-32. DOI: 10.1016/0002-8703(85)90630-1. View

11.

Cain M, Ambos H, Markham J, Lindsay B, Arthur R . Diagnostic implications of spectral and temporal analysis of the entire cardiac cycle in patients with ventricular tachycardia. Circulation. 1991; 83(5):1637-48. DOI: 10.1161/01.cir.83.5.1637. View

12.

Tsuboi N, Kodama I, TOYAMA J, Yamada K . Anisotropic conduction properties of canine ventricular muscles. Influence of high extracellular K+ concentration and stimulation frequency. Jpn Circ J. 1985; 49(5):487-98. DOI: 10.1253/jcj.49.487. View

13.

Zimmermann M, Friedli B, Adamec R, Oberhansli I . Frequency of ventricular late potentials and fractionated right ventricular electrograms after operative repair of tetralogy of Fallot. Am J Cardiol. 1987; 59(5):448-53. DOI: 10.1016/0002-9149(87)90954-4. View

14.

SPACH M, Dolber P . Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle. Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circ Res. 1986; 58(3):356-71. DOI: 10.1161/01.res.58.3.356. View

15.

Rozanski J, Mortara D, Myerburg R, Castellanos A . Body surface detection of delayed depolarizations in patients with recurrent ventricular tachycardia and left ventricular aneurysm. Circulation. 1981; 63(5):1172-8. DOI: 10.1161/01.cir.63.5.1172. View

16.

Greenspon A, Volosin K . The effects of atrial pacing on the signal-averaged electrocardiogram in patients with coronary artery disease. Am Heart J. 1990; 119(1):29-34. DOI: 10.1016/s0002-8703(05)80077-8. View

17.

Simson M . Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction. Circulation. 1981; 64(2):235-42. DOI: 10.1161/01.cir.64.2.235. View

18.

Ozawa Y, Yakubo S, Tanigawa N, Nagasawa M, Kojima R, Jinno K . The clinical evaluation of the late potentials in patients with ventricular arrhythmias. Jpn Circ J. 1987; 51(2):230-41. DOI: 10.1253/jcj.51.230. View

19.

Southall D, Johnson A, Shinebourne E, Johnston P, Vulliamy D . Frequency and outcome of disorders of cardiac rhythm and conduction in a population of newborn infants. Pediatrics. 1981; 68(1):58-66. View

20.

Stelling J, Danford D, Kugler J, Windle J, Cheatham J, Gumbiner C . Late potentials and inducible ventricular tachycardia in surgically repaired congenital heart disease. Circulation. 1990; 82(5):1690-6. DOI: 10.1161/01.cir.82.5.1690. View