Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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P wave dispersion on 12-lead electrocardiography in adolescents with neurocardiogenic syncope

  • Lee, Dong-Hyuk (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lee, Kyung-Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Yoon, Jung-Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae-Woo (Department of Pediatrics, Konyang University College of Medicine) ;
  • Kho, Kyung-Ok (Department of Pediatrics, Konyang University College of Medicine) ;
  • Kil, Hong-Ryang (Department of Pediatrics, Chungnam National University College of Medicine) ;
  • Cheon, Eun-Jung (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2016.04.29
  • Accepted : 2016.09.29
  • Published : 2016.11.15
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Abstract

Purpose: Neurocardiogenic syncope (NCS) is the most frequent cause of fainting during adolescence. Inappropriate cardiovascular autonomic control may be responsible for this clinical event. The head-up tilt test has been considered a diagnostic standard, but it is cumbersome and has a high false-positive rate. We performed a study to evaluate whether P-wave dispersion (PWD) could be a useful electrocardiographic parameter of cardiac autonomic dysfunction in children with NCS. Methods: Fifty-four patients with NCS (28 boys and 26 girls; mean age, $12.3{\pm}1.4$ years) and 55 age- and sex-matched healthy controls were enrolled. PWD was obtained as the difference between maximum and minimum durations of the P wave on standard 12-lead electrocardiography in all patients and controls Results: The value of PWD was significantly higher in the syncope group than in the control group ($69.7{\pm}19.6$ msec vs. $45.5{\pm}17.1$ msec, respectively; P<0.001). The minimum duration of P wave was shorter in the syncope group than in the control group ($43.8{\pm}16.8$ msec vs. $53.5{\pm}10.7$ msec, respectively; P<0.001). Left atrial volume was not different between the groups on transthoracic echocardiography. Conclusion: PWD on echocardiography could be used as a clinical parameter in patients with NCS.

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References

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