["Left anterior hemiblock" or "extreme left axis deviation" in the ECG of children].

A comprehensive study involving the use of ECG's from children at the Giessen University Children's Hospital was conducted with the specific intent of identifying all children with an extreme left-axis deviation. This study showed that, in a time period of five years, 212 out of 3618 children examined electrocardiographically had an extreme left-axis deviation according to very strict criteria, their ECG-types could be divided into three groups: 1. without heart defects, 2. with congenital heart anomalies, 3. after surgery for congenital heart problems. Measurement of the QRS-complex in eighty children without heart defect showed that fifty-nine of the children (73.8%) had a vector -QRS between -30 degrees to -90 degrees. Ih the 88 children with congenital heart defects, and in 20 with an extreme left-axis deviation previous to surgery, an angle of -60 degrees to -90 degrees was found, most often in children with complete A-V canals of Down's Syndrome (as well as in children with transposition of the great arteries, univentricular heart or other complicated malformations of the heart). And finally, an extreme left axis deviation was very often found after surgery to correct Tetralogy of Fallot, ventricular defect, or endocardial cushion defect. Since an extreme left-axis deviation often occurs in children without heart defects, we would like to suggest that the term "Left anterior Hemiblock" be reserved for cases where there is certainty that damage to the conduction system has occurred. In all other cases, we prefer the term "left-axis deviation" as a more appropriate because an anomaly in the conduction system is more likely than a "block" i.e. an interruption of the conduction of electrical impulses through the heart muscle.