Microvolt T-Wave Alternans during Holter Monitoring in Children and Adolescents
Methods: We examined 68 healthy patients—newborns (20) and children in age group of 7–17 years (48)—and 85 pediatric patients: ventricular premature beats—65; dilated cardiomyopathy (DCMP)—2; long QT syndrome (LQTS)—10; Brugada syndrome (BrS)—5, catecholaminergic ventricular tachycardia (CVT)—3. All underwent Holter monitoring (HM) with definition of the peak value of TWA by modified moving average method.
Results: In healthy newborns, TWA was 32 ± 8 (12–55) V (HR 123–156 bmp). In healthy children (7–17 years) it was 30 ± 11 (10–l 55) V, (HR 64–132 bmp) without any differences between boys and girls. In all group of patients, TWA were significantly higher (P < 0.05) than in healthy. Circadian peak of TWA was found (90%) in a second part of day and at sleep (8%). Among them 60% (LQTS, BrS, and DCPM) had TWA > 55 V.
Conclusion: Time-domain TWA during HM in children was independent of age, gender, and heart rate. In 94% healthy children, values of TWA do not exceed 55 V but 20–50% children with cardiac pathology had TWA more than 55 V. Night circadian type of TWA in diseases with risk of life-threatening arrhythmias associated with TWA was more than 55 V.
Ann Noninvasive Electrocardiol 2010;15(2):138–144
Document Type: Research Article
Affiliations: Center for Syncope and Cardiac Arrhythmias in Children and Adolescents of the Federal Medical-Biological Agency of Russia, Clinical Children Hospital #38 of Federal Medical-Biological Agency of Russia, Moscow, Russia
Publication date: April 1, 2010