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European Heart Journal 2001 22(8):702-711; doi:10.1053/euhj.2000.2399
Copyright © 2001 by the European Society of Cardiology.
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New normal limits for the paediatric electrocardiogram

P.R Rijnbeeka,f1, M Witsenburgb, E Schramab, J Hessc and J.A Korsa

a Institute of Medical Informatics, Faculty of Medicine and Health Sciences, Erasmus University, Rotterdam, The Netherlands
b Department of Paediatric Cardiology, Sophia Children's Hospital, Rotterdam, The Netherlands
c Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Munich, Germany

revised July 21, 2000; accepted July 26, 2000

Abstract

Aims Previous studies that determined the normal limits for the paediatric ECG had their imperfections: ECGs were recorded at a relatively low sampling rate, ECG measurements were conducted manually, or normal limits were presented for only a limited set of parameters. The aim of this study was to establish an up-to-date and complete set of clinically relevant normal limits for the paediatric ECG.

Methods and Results ECGs from 1912 healthy Dutch children (age 11 days to 16 years) were recorded at a sampling rate of 1200Hz. The digitally stored ECGs were analysed using a well-validated ECG computer program. The normal limits of all clinically relevant ECG measurements were determined for nine age groups. Clinically significant differences were shown to exist, compared with previously established normal limits. Sex differences could be demonstrated for QRS duration and several amplitude measurements.

Conclusions These new normal limits differ substantially from those commonly used and suggest that diagnostic criteria for the paediatric ECG should be adjusted.

Key Words: Electrocardiography, paediatrics, normal limits, computer

f1 Correspondence: Peter R. Rijnbeek, MSc., Institute of Medical Informatics, Faculty of Medicine and Health Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.

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