Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1981 Mar;45(3):281–291. doi: 10.1136/hrt.45.3.281

24-hour electrocardiographic study of heart rate and rhythm patterns in population of healthy children.

D P Southall, F Johnston, E A Shinebourne, P G Johnston
PMCID: PMC482524  PMID: 7470341

Abstract

Twenty-four hour electrocardiographic recordings were made on 104 randomly selected, healthy 7 to 11-year-old children. Ninety-two were technically adequate and suitable for analysis. The mean highest heart rate measured by direct electrocardiographic analysis over nine beats was 164 +/- 17. The mean lowest heart rates were 49 +/- 6 over three beats', and 56 +/- 6 over nine beats' duration. The maximum duration of heart rates less than 55/minute was 40 minutes. At their lowest heart rates 41 children (45 per cent) had junctional escape rhythms, the maximum duration of which was 25 minutes. Nine children showed PR intervals greater than or equal to 0.20 s and included three with Mobitz type I second degree atrioventricular block. Nineteen (21%) had isolated supraventricular or ventricular premature beats (less than 1/hour). Sixty subjects (65%) had sinus pauses that could not be distinguished on the surface electrocardiogram from those previously described as sinuatrial exit block or sinus arrest. The maximum duration of sinus pause measured over 24 hours on each child was 1.36 +/- 0.23 seconds. Thus apparently healthy children show variations in heart rate and rhythm over 24 hours hitherto considered to be abnormal.

Full text

PDF
284

Images in this article

282Image
on p.282
282Image
on p.282
283Image
on p.283
283Image
on p.283
284Image
on p.284
286Image
on p.286
287Image
on p.287
288Image
on p.288
289Image
on p.289

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brodsky M., Wu D., Denes P., Kanakis C., Rosen K. M. Arrhythmias documented by 24 hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease. Am J Cardiol. 1977 Mar;39(3):390–395. doi: 10.1016/s0002-9149(77)80094-5. [DOI] [PubMed] [Google Scholar]
  2. CULLEN K. J., COLLIN R. DAILY RUNNING CAUSING WENCKEBACH HEART-BLOCK. Lancet. 1964 Oct 3;2(7362):729–730. doi: 10.1016/s0140-6736(64)92547-4. [DOI] [PubMed] [Google Scholar]
  3. El-Said G. M., Gillette P. C., Cooley D. A., Mullins C. E., McNamara D. G. Protection of the sinus node in Mustard's operation. Circulation. 1976 May;53(5):788–791. doi: 10.1161/01.cir.53.5.788. [DOI] [PubMed] [Google Scholar]
  4. Ferrer M. I. The sick sinus syndrome. Circulation. 1973 Mar;47(3):635–641. doi: 10.1161/01.cir.47.3.635. [DOI] [PubMed] [Google Scholar]
  5. GRIMBY G., SALTIN B. DAILY RUNNING CAUSING WENCKEBACH HEART-BLOCK. Lancet. 1964 Oct 31;2(7366):962–963. doi: 10.1016/s0140-6736(64)90896-7. [DOI] [PubMed] [Google Scholar]
  6. Gambetta M., Denes P., Childers R. W. Vagally induced second degree A-V block Mobitz type I, and the hyporeactive SA node. Chest. 1972 Aug;62(2):152–155. doi: 10.1378/chest.62.2.152. [DOI] [PubMed] [Google Scholar]
  7. Goldreyer B. N., Damato A. N. Sinoatrial-node entrance block. Circulation. 1971 Nov;44(5):789–802. doi: 10.1161/01.cir.44.5.789. [DOI] [PubMed] [Google Scholar]
  8. Greenwood R. D., Rosenthal A., Sloss L. J., LaCorte M., Nadas A. S. Sick sinus syndrome after surgery for congenital heart disease. Circulation. 1975 Aug;52(2):208–213. doi: 10.1161/01.cir.52.2.208. [DOI] [PubMed] [Google Scholar]
  9. JOHNSON R. L., AVERILL K. H., LAMB L. E. Electrocardiographic findings in 67,375 asymptomatic subjects. VII. Atrioventricular block. Am J Cardiol. 1960 Jul;6:153–177. doi: 10.1016/0002-9149(60)90044-8. [DOI] [PubMed] [Google Scholar]
  10. Kaplan B. M., Langendorf R., Lev M., Pick A. Tachycardia-bradycardia syndrome (so-called "sick sinus syndrome"). Pathology, mechanisms and treatment. Am J Cardiol. 1973 Apr;31(4):497–508. doi: 10.1016/0002-9149(73)90302-0. [DOI] [PubMed] [Google Scholar]
  11. Lightfoot P. R., Sasse L., Mandel W. J., Hayakawa H. His bundle electrograms in healthy adolescents with persistent second degree A-V block. Chest. 1973 Mar;63(3):358–362. doi: 10.1378/chest.63.3.358. [DOI] [PubMed] [Google Scholar]
  12. MANNING G. W., SEARS G. A. Postural heart block. Am J Cardiol. 1962 Apr;9:558–563. doi: 10.1016/0002-9149(62)90074-7. [DOI] [PubMed] [Google Scholar]
  13. Meytes I., Kaplinsky E., Yahini J. H., Hanne-Paparo N., Neufeld H. N. Wenckebach A-V block: a frequent feature following heavy physical training. Am Heart J. 1975 Oct;90(4):426–430. doi: 10.1016/0002-8703(75)90421-4. [DOI] [PubMed] [Google Scholar]
  14. Onat A., Domaniç N., Onat T. Sick sinus syndrome in an infant: severe disturbance of impulse formation and conduction involving the S-A node and the A-V junctional tissue. Eur J Cardiol. 1974 Aug;2(1):79–83. [PubMed] [Google Scholar]
  15. Radford D. J., Izukawa T. Sick sinus syndrome. Symptomatic cases in children. Arch Dis Child. 1975 Nov;50(11):879–885. doi: 10.1136/adc.50.11.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Saalouke M. G., Rios J., Perry L. W., Shapiro S. R., Scott L. P. Electrophysiologic studies after mustard's operation for d-transposition of the great vessels. Am J Cardiol. 1978 May 22;41(6):1104–1109. doi: 10.1016/0002-9149(78)90864-0. [DOI] [PubMed] [Google Scholar]
  17. Schamroth L., Dove E. The Wenckebach phenomenon in sino-atrial block. Br Heart J. 1966 May;28(3):350–358. doi: 10.1136/hrt.28.3.350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Scott O., Macartney F. J., Deverall P. B. Sick sinus syndrome in children. Arch Dis Child. 1976 Feb;51(2):100–105. doi: 10.1136/adc.51.2.100. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Southall D. P., Keeton B. R., Leanage R., Lam L., Joseph M. C., Anderson R. H., Lincoln C. R., Shinebourne E. A. Cardiac rhythm and conduction before and after Mustard's operation for complete transposition of the great arteries. Br Heart J. 1980 Jan;43(1):21–30. doi: 10.1136/hrt.43.1.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Southall D. P., Orrell M. J., Talbot J. F., Brinton R. J., Vulliamy D. G., Johnson A. M., Keeton B. R., Anderson R. H., Shinebourne E. A. Study of cardiac arrhythmias and other forms of conduction abnormality in newborn infants. Br Med J. 1977 Sep 3;2(6087):597–599. doi: 10.1136/bmj.2.6087.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Southall D. P., Richards J., Mitchell P., Brown D. J., Johnston P. G., Shinebourne E. A. Study of cardiac rhythm in healthy newborn infants. Br Heart J. 1980 Jan;43(1):14–20. doi: 10.1136/hrt.43.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Thormann J., Schwarz F., Ensslen R., Sesto M. Vagal tone, significance of electrophysiologic findings and clinical course in symptomatic sinus node dysfunction. Am Heart J. 1978 Jun;95(6):725–731. doi: 10.1016/0002-8703(78)90502-1. [DOI] [PubMed] [Google Scholar]
  23. Urbach J. R., Phuvichit B., Zweizig H., Millican E., Carrington E. R., Loveland M., Williams J. M., Lambert R. L., Duncan A. M., Farrell S. L. Instantaneous heart rate patterns in newborn infants. Am J Obstet Gynecol. 1965 Dec 1;93(7):965–974. doi: 10.1016/0002-9378(65)90157-2. [DOI] [PubMed] [Google Scholar]
  24. Wu D., Amat-y-leon F., Denes P., Dhingra R. C., Pietras R. J., Rosen K. M. Demonstration of sustained sinus and atrial re-entry as a mechanism of paroxysmal supraventricular tachycardia. Circulation. 1975 Feb;51(2):234–243. doi: 10.1161/01.cir.51.2.234. [DOI] [PubMed] [Google Scholar]
  25. Yabek S. M., Jarmakani J. M., Roberts N. K. Sinus node function in children. Factors influencing its evaluation. Circulation. 1976 Jan;53(1):28–33. doi: 10.1161/01.cir.53.1.28. [DOI] [PubMed] [Google Scholar]
  26. Yabek S. M., Jarmakani J. M. Sinus node dysfunction in children, adolescents, and young adults. Pediatrics. 1978 Apr;61(4):593–598. [PubMed] [Google Scholar]
  27. Yabek S. M., Swensson R. E., Jarmakani J. M. Electrocardiographic recognition of sinus node dysfunction in children and young adults. Circulation. 1977 Aug;56(2):235–239. doi: 10.1161/01.cir.56.2.235. [DOI] [PubMed] [Google Scholar]
  28. Young D., Eisenberg R. E. Symptomatic sinus arrest in a young girl. Arch Dis Child. 1977 Apr;52(4):331–334. doi: 10.1136/adc.52.4.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Young D., Eisenberg R., Fish B., Fisher J. D. Wenckebach atrioventricular block (Mobitz type I) in children and adolescents. Am J Cardiol. 1977 Sep;40(3):393–399. doi: 10.1016/0002-9149(77)90161-8. [DOI] [PubMed] [Google Scholar]
  30. el-Said G., Rosenberg H. S., Mullins C. E., Hallman G. L., Cooley D. A., McNamara D. G. Dysrhythmias after Mustard's operation for transposition of the treat arteries. Am J Cardiol. 1972 Oct;30(5):526–532. doi: 10.1016/0002-9149(72)90043-4. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES