Prevalence of Interatrial Block in Healthy School-Aged Children: Definition by P-Wave Duration or Morphological Analysis
Article first published online: 20 JAN 2010
©2010, Wiley Periodicals, Inc.
Annals of Noninvasive Electrocardiology
Volume 15, Issue 1, pages 17–25, January 2010
How to Cite
Dilaveris, P., Raftopoulos, L., Giannopoulos, G., Katinakis, S., Maragiannis, D., Roussos, D., Gatzoulis, K., Michaelides, A. and Stefanadis, C. (2010), Prevalence of Interatrial Block in Healthy School-Aged Children: Definition by P-Wave Duration or Morphological Analysis. Annals of Noninvasive Electrocardiology, 15: 17–25. doi: 10.1111/j.1542-474X.2009.00335.x
- Issue published online: 20 JAN 2010
- Article first published online: 20 JAN 2010
- P-wave duration;
- orthogonal P-wave morphology;
- interatrial block;
Background: P waves ≥110 ms in adults and ≥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 ± 9.5 ms, maximum P-wave duration 99.0 ± 9.8 ms, P dispersion 32.2 ± 12.5 ms, spatial P amplitude 182.7 ± 69.0 μV. 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.
Ann Noninvasive Electrocardiol 2010;15(1):17–25