Incidence of Pathological Electrocardiographic Findings and Role of Electrocardiographic Screening in the Population of First Grade Pupils in Latvia



Kristine Jubele1,2, Agnese Knipse2, Olga Sesunaceva1, Armands Buls2, Oskars Kalejs1,2, Aivars Lejnieks1,3
1 Faculty of Internal Medicine, Riga Stradins University, Latvia
2 Arrhythmology, P.Stradins University Hospital, Latvia
3 Clinic of Internal Diseases, Riga Eastern Clinical University Hospital, Latvia

Aim: To determine the incidence of abnormal ECG findings and role of electrocardiographic screening in the population of first grade pupils in Latvia.

Material and Methods: 12 lead ECGs were performed in 852 first grade pupils in Latvia. Data analysis was based on the measurements, done automatically, but in case of doubt the measurements were checked visually. The data were analyzed, using Microsoft Excel 2010 and SPSS 20 programmes.

Results: The 12 lead ECGs of 852 first grade pupils were done. There were 412 boys and 440 girls among the children investigated. SV1+RV6 >47mm was found in 11(1.29%) children of the population investigated. Left ventricular hypertrophy was not found in any of them by echocardiography. Arrhythmogenic right ventricular cardiomyopathy was not confirmed in a child with Epsilon wave on ECG. 8(0.94%) children with bradycardia showed no significant slowing of heart rate in Holter monitoring. The standard of normal ECG percentiles was developed, different from what has been used so far. An algorithm of ECG evaluation in 7-8 year old children was performed.

Conclusions:

  1. SV1+RV6 >47mm did not show any correlation with left ventricular hypertrophy by echocardiography.
  2. Children with bradicardia in ECG showed an adequate increase of heart rate in Holter monitoring.
  3. Further research is needed to determine ECG criteria of left ventricular hypertrophy in children.
  4. The number of the children was insufficient to identifyr familial cardiomyopathy.
  5. The standard of normal ECG percentiles in the age group 7-8 years was developed.
  6. An algorithm of ECG evaluation in 7-8 year old children was performed.
  7. The role of ECG screening is still disputable in first grade pupils’ population due to a low possibility of pathological finding and low specificity and sensivity of this examination. However, there are several diseases that can be diagnosedd only by ECG and which do not manifest themselves till first, potentially fatal, incident.