Pediatric electrocardiography
Tips for ECG recording in children
Limb electrodes may be placed more proximally on the limbs than the conventional distal placement. This will produce less movement artefacts in children who are less likely to stay quiet during the entire period of record. V3R and V4R should be recorded in addition to the standard 12 leads. Standard paper speed (25 mm/s) and gain (10 mm / mV) are used for paediatric recordings also. Half gain (5 mm / mV) recordings are done if the complexes are large. Recording can be done under sedation or during natural sleep or sometimes even by distraction techniques to keep the child quiet.
Indications for ECG in children
Chest pain is seldom of cardiac origin in children, even though an ECG is often obtained for chest pain in children as in adults. Important indications for ECG in children:
Syncope
Exertional symptoms
Tachyarrhythmia
Bradyarrhythmia
Cyanotic episodes
Heart failure
Electrolyte disturbance
Congenital or rheumatic heart disease
Kawasaki disease
Myocarditis
Pericarditis
Evolution of ECG with age
Right ventricular dominance is the rule in ECG of neonates and is characterised by right axis deviation, tall R and T inversion in V1. Upright T waves in V1 abnormal after the first 72 hours of life.
Resting heart rate varies with the age, progressively decreasing as age increases: newborn: 140 / min; 1 year: 120 / min; 5 years: 100 / min; adult values being reached by about 10 years of age.
PR interval also progressively increases as age advance...
Source: Cardiophile MD - Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs
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