New normal limits for the paediatric electrocardiogram

Aims Previous studies that determined the normal limits for the paediatric ECG had their imperfections: ECGs were recorded at a relatively low samplin g rate, ECG measurements were conducted manually, or normal limits were pre sented for only a limited set of parameters. The aim of this study was to e stablish an up-to-date and complete set of clinically relevant normal limit s for the paediatric ECG. Methods and Results ECGs from 1912 healthy Dutch children (age 11 days to 1 6 years) were recorded at a sampling rate of 1200 Hz. The digitally stored ECGs were analysed using a well-validated ECG computer program. The normal limits of all clinically relevant ECG measurements were determined for nine age groups. Clinically significant differences were shown to exist, compar ed with previously established normal limits. Sex differences could be demo nstrated for QRS duration and several amplitude measurements. Conclusions These new normal limits differ substantially from those commonl y used and suggest that diagnostic criteria for the paediatric ECG should h e adjusted.