Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital Auckland New Zealand; The University of Auckland, Department of Child Health, Auckland, New Zealand; Green Lane Cardiovascular Services, Auckland City Hospital, Auckland, New Zealand.
The University of Auckland, Department of Child Health, Auckland, New Zealand.
Heart Lung Circ. 2020 Oct;29(10):1469-1475. doi: 10.1016/j.hlc.2019.12.006. Epub 2019 Dec 24.
Normative values for heart-rate corrected repolarisation length are not available in children and are scarce in adults. We wished to define repeatability and normative values of Holter recording measurements of repolarisation length in healthy individuals using a commercially available system, and compare measurements with those from 12-lead electrocardiograms (ECGs).
Twenty-four-hour (24-) Holter recordings were made on 99 Healthy volunteers: 52 children (7 months to 14 years) and 47 adults (≥15 yrs). Mean and peak values of QTc, and RTPc (R-wave to peak T-wave) were assessed. Bazett heart rate correction was employed for each measurement and only heart rates between 40 and 120 bpm were analysed. The end of the T-wave was defined from the zero-crossing point. QTc was also determined from 12-lead ECGs from the same population by manual measurement recording the longest QTc of leads 2 and V5. The tangent technique was used to define the end of the T-wave.
Interobserver repeatability: mean QTc ±15 ms (CI 3.5%), peak QTc ±25 ms (CI 4.5%), mean RTPc ±3 ms (CI 1%), peak RTPc ±44 ms (CI 11%). Mean values were very similar for <15 years and all females and were therefore amalgamated: mean (±2 SD); mean QTc 424 ms (394-454), mean RTPc 291ms (263-319). Values were lower in males ≥15 years; (mean QTc 408 ms (370-446), p<0.01; mean RTPc 274 ms (234-314), p<0.01. The highest mean QTc value was 467 ms in an adult female. QTc from 12-lead ECG: females <15 years 409 ms (384-434) males <15 years 408 ms (383-433), females ≥15 years 426 ms (401-451), males ≥15 years 385 ms (362-408).
Holter measurements of mean QTc and RTPc are highly repeatable. Males ≥15 years have shorter mean repolarisation length over 24 hours than males <15 years and all females. Mean QTc Holter values were on average 15-17 ms longer than QTc from 12-lead ECGs except in females >15 years.
目前尚缺乏儿童心率校正复极间期的正常值，而成人正常值也十分有限。本研究旨在使用市售系统，对健康个体的动态心电图记录的复极间期测量值进行重复性和正常值定义，并与 12 导联心电图（ECG）的测量值进行比较。
对 99 名健康志愿者进行 24 小时动态心电图监测：52 名儿童（7 个月至 14 岁）和 47 名成年人（≥15 岁）。评估 QTc 和 RTPc（R 波到 T 波峰）的均值和峰值。对每个测量值均采用 Bazett 心率校正，仅分析心率在 40 至 120 bpm 之间的测量值。T 波终点通过零线交叉点定义。来自同一人群的 12 导联 ECG 也通过手动测量记录 2 导联和 V5 导联的最长 QTc 来确定 QTc。切线技术用于定义 T 波终点。
观察者间重复性：平均 QTc ±15 ms（置信区间 3.5%），峰值 QTc ±25 ms（置信区间 4.5%），平均 RTPc ±3 ms（置信区间 1%），峰值 RTPc ±44 ms（置信区间 11%）。<15 岁和所有女性的平均 QTc 值非常相似，因此将其合并：平均（±2 个标准差）；平均 QTc 424 ms（394-454），平均 RTPc 291 ms（263-319）。≥15 岁的男性值较低；（平均 QTc 408 ms（370-446），p<0.01；平均 RTPc 274 ms（234-314），p<0.01）。一名成年女性的最高平均 QTc 值为 467 ms。12 导联 ECG 的 QTc：<15 岁女性 409 ms（384-434），<15 岁男性 408 ms（383-433），≥15 岁女性 426 ms（401-451），≥15 岁男性 385 ms（362-408）。
动态心电图的平均 QTc 和 RTPc 测量值具有高度重复性。≥15 岁的男性与<15 岁的男性和所有女性相比，24 小时内的平均复极间期较短。除 15 岁以上女性外，动态心电图平均 QTc 值比 12 导联 ECG 的 QTc 值平均长 15-17 ms。
