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ECG in the Child and Adolescent - part 3 pptx

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Striking changes in heart rate are noted from newborn to adolescence.. The heart rate increases from birth to ages 7–30, days and 1–3 months.. From that age forward, the heart rate decre

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Heart rate by age

50 60 70 80 90 100 110 120 130 140 150 160 170 180 190

0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18

95%

75%

50%

25%

5%

Figure 1.1 Heart rate by age, each curve corresponding to the indicated percentile level ( • = mean) Striking changes in heart rate are noted from newborn to adolescence The heart rate

increases from birth to ages 7–30, days and 1–3 months From that age forward, the heart rate decreases with increasing age, most rapidly from age 6–12 months to 1–3 years

Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18

(±SD) 12.86 13.07 15.91 15.58 14.66 11.70 18.67 13.09 11.96 14.68 14.08 14.50

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PR interval by age

70

80

90

100

110

120

130

140

150

160

170

180

0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18

95%

75%

50%

25%

5%

Age, days Age, months Age, years

Figure 1.2 PR interval by age, each curve corresponding to the indicated percentile level ( • = mean) The PR interval remains little changed after birth and during early infancy It

increases with increasing age, from age 6 months through to adolescence

Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18

(±SD) 10.65 11.54 12.65 13.48 11.81 11.36 12.93 10.85 10.56 14.52 17.35 17.94

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PR interval by heart rate

0 20 40 60 80 100 120 140 160 180 200

150-Heart Rate per Minute

95%

75%

50%

25%

5%

Figure 1.3 PR Interval by heart rate, each curve corresponding to the indicated percentile

entire pediatric ages

Heart

rate 1–69 70–79 80–89 90–99 100–109 110–119 120–129 130–139 140–149 150–

(±SD) 21.54 18.53 15.96 13.71 14.91 17.48 14.94 0.00 0.00 0.00

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QT interval by age

0 50

100

150

200

250

300

350

400

450

0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18

95% 75% 50% 25% 5%

Age, years Age, days Age, months

Figure 1.4 QT interval by age, each curve corresponding to the indicated percentile level ( • = mean) The QT interval decreases slightly after birth, reaching the lowest at age 7–30 days.

From that age forward, the QT interval increases along with increasing age up to adolescence

Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18

(±SD) 26.63 23.09 17.92 17.85 18.90 15.95 23.81 21.69 21.11 23.41 26.02 27.00

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QT interval by heart rate

200 215 230 245 260 275 290 305 320 335 350 365 380 395 410 425 440 455 470 485 500

150-Heart Rate per Minute

95%

75%

50% 25% 5%

Figure 1.5 QT interval by heart rate, each curve corresponding to the indicated percentile

Heart

rate 1–69 70–79 80–89 90–99 100–109 110–119 120–129 130–139 140–149 150–

(±SD) 21.54 17.50 15.46 14.51 15.18 16.39 15.61 0.00 0.00 0.00

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QTc interval by age

0 100

200

300

400

500

600

0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18

95%

75%

50%

25%

5%

Figure 1.6 QTc interval by age, each curve corresponding to the indicated percentile level ( • = mean) The corrected QT interval decreases slightly after birth, and returns to the previous

level by age 1–3 months, then remains unchanged until adolescence

Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18

(±SD) 26.44 23.09 19.15 25.15 20.56 17.50 20.17 16.27 15.83 18.09 17.35 23.52

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QTc interval by heart rate

300 320 340 360 380 400 420 440 460 480

150-Heart Rate per Minute

95%

75%

50%

25%

5%

Figure 1.7 QTc interval by heart rate, each curve corresponding to the indicated percentile

rate up to a rate of 110–119 per minute, then remains little or unchanged

Heart

rate 1–69 70–79 80–89 90–99 100–109 110–119 120–129 130–139 140–149 150–

(±SD) 22.76 19.70 17.90 18.44 19.74 22.19 21.81 0.00 0.00 0.00

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QRS duration by age

0 20

40

60

80

100

120

0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18

95%

75%

50%

25%

5%

Figure 1.8 QRS duration by age, each curve corresponding to the indicated percentile level ( • = mean) QRS duration steadily and gradually increases with increasing age, from birth to

adolescence

Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18

(±SD) 10.65 11.54 9.44 8.06 10.55 8.31 9.04 10.85 10.56 7.53 8.67 9.85

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RR interval by age

0 200 400 600 800 1000 1200

0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18

95%

75%

50%

25%

5%

Age, years

Figure 1.9 RR interval by age, each curve corresponding to the indicated percentile level ( • = mean) The RR interval decreases slightly from birth to ages 7–30 days and 1–3 months.

From that age forward, the RR interval increases with a wider range along with increasing age until adolescence

Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18

(±SD) 47.94 46.18 53.46 48.33 40.57 37.92 71.09 75.93 79.16 96.94 95.41 138.81

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