BACKGROUND: P waves > or = 110 ms in adults and > or = 90 ms in children are considered abnormal, signifying interatrial block, particularly in the first case. METHODS: To evaluate the prevalence of interatrial block in healthy school-aged children, we obtained 12-lead digital ECGs (Cardioperfect 1.1, CardioControl NV, Delft, The Netherlands) of 664 healthy children (349 males/315 females, age range 6-14 years old). P-wave analysis indices [mean, maximum and minimum (in the 12 leads) P-wave duration, P-wave dispersion, P-wave morphology in the derived orthogonal (X, Y, Z) leads, as well the amplitude of the maximum spatial P-wave vector] were calculated in all study participants. RESULTS: P-wave descriptor values were: mean P-wave duration 84.9 + or - 9.5 ms, maximum P-wave duration 99.0 + or - 9.8 ms, P dispersion 32.2 + or - 12.5 ms, spatial P amplitude 182.7 + or - 69.0 microV. P-wave morphology distribution in the orthogonal leads were: Type I 478 (72.0%), Type II 178 (26.8%), Type III 1 (0.2%), indeterminate 7 (1%). Maximum P-wave duration was positively correlated to age (P < 0.001) and did not differ between sexes (P = 0.339). Using the 90-ms value as cutoff for P-wave duration, 502 (75.6%) children would be classified as having maximum P-wave duration above reference range. The 95th and the 99th percentiles were in the overall population 117 ms and 125 ms, respectively. P-wave morphology type was not in any way correlated to P-wave duration (P = 0.715). CONCLUSIONS: Abnormal P-wave morphology signifying the presence of interatrial block is very rare in a healthy pediatric population, while widened P waves are quite common, although currently classified as abnormal.
BACKGROUND: P waves > or = 110 ms in adults and > or = 90 ms in children are considered abnormal, signifying interatrial block, particularly in the first case. METHODS: To evaluate the prevalence of interatrial block in healthy school-aged children, we obtained 12-lead digital ECGs (Cardioperfect 1.1, CardioControl NV, Delft, The Netherlands) of 664 healthy children (349 males/315 females, age range 6-14 years old). P-wave analysis indices [mean, maximum and minimum (in the 12 leads) P-wave duration, P-wave dispersion, P-wave morphology in the derived orthogonal (X, Y, Z) leads, as well the amplitude of the maximum spatial P-wave vector] were calculated in all study participants. RESULTS: P-wave descriptor values were: mean P-wave duration 84.9 + or - 9.5 ms, maximum P-wave duration 99.0 + or - 9.8 ms, P dispersion 32.2 + or - 12.5 ms, spatial P amplitude 182.7 + or - 69.0 microV. P-wave morphology distribution in the orthogonal leads were: Type I 478 (72.0%), Type II 178 (26.8%), Type III 1 (0.2%), indeterminate 7 (1%). Maximum P-wave duration was positively correlated to age (P < 0.001) and did not differ between sexes (P = 0.339). Using the 90-ms value as cutoff for P-wave duration, 502 (75.6%) children would be classified as having maximum P-wave duration above reference range. The 95th and the 99th percentiles were in the overall population 117 ms and 125 ms, respectively. P-wave morphology type was not in any way correlated to P-wave duration (P = 0.715). CONCLUSIONS: Abnormal P-wave morphology signifying the presence of interatrial block is very rare in a healthy pediatric population, while widened P waves are quite common, although currently classified as abnormal.
Authors: P E Dilaveris; G K Andrikopoulos; G Metaxas; D J Richter; C K Avgeropoulou; A M Androulakis; E J Gialafos; A P Michaelides; P K Toutouzas; J E Gialafos Journal: Pacing Clin Electrophysiol Date: 1999-11 Impact factor: 1.976
Authors: A Bayes de Luna; R Fort de Ribot; E Trilla; J Julia; J Garcia; J Sadurni; J Riba; F Sagues Journal: J Electrocardiol Date: 1985-01 Impact factor: 1.438
Authors: Fredrik Holmqvist; Daniela Husser; Jari M Tapanainen; Jonas Carlson; Raija Jurkko; Yunlong Xia; Rasmus Havmöller; Ole Kongstad; Lauri Toivonen; S Bertil Olsson; Pyotr G Platonov Journal: Heart Rhythm Date: 2007-12-23 Impact factor: 6.343