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EDITORIAL
Year : 2014  |  Volume : 11  |  Issue : 2  |  Page : 65

Electrocardiographic reference values for Nigerian children


Department of Child Health, Pediatric Cardiology Unit, University of Benin, University of Benin Teaching Hospital, Benin City, Nigeria

Date of Web Publication3-Oct-2014

Correspondence Address:
Wilson E Sadoh
Department of Child Health, Pediatric Cardiology Unit, University of Benin, University of Benin Teaching Hospital, P.M.B. 1111, Benin City
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0189-7969.142080

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How to cite this article:
Sadoh WE. Electrocardiographic reference values for Nigerian children. Nig J Cardiol 2014;11:65

How to cite this URL:
Sadoh WE. Electrocardiographic reference values for Nigerian children. Nig J Cardiol [serial online] 2014 [cited 2019 Mar 26];11:65. Available from: http://www.nigjcardiol.org/text.asp?2014/11/2/65/142080

The electrocardiogram (ECG) was invented by Willem Eithoven [1] in the late twentieth century. The contribution of Emmanuel Goldberger [1] in adding augmented and chest leads has made recording the electrical activities of the heart a formidable tool in the management of heart-related disorders. These disorders range from arrhythmias, ischemic heart disease, and structural heart anomalies to electrolytes imbalances. There are established racial, gender-related, and age-related differences in ECG findings amongst patients. [2] This is particularly important in pediatric practice where interpretation of ECG is based on normal cut offs for amplitudes and duration of intervals/variables. Some intervals/variables such as the PR and QRS intervals as well as the QRS axis are age dependent. Others are also dependent on heart rate, which is also a function of age. Thus, the correct interpretation of pediatric ECG should be with the knowledge of established normative values. Caucasian reference values have hitherto been used for African children because of the absence of well-derived African values. Reference values are often generated from ECG recordings from a large number of normal children.

The Nigerian studies that evaluated ECG findings in normal children were however limited by the small sample size and poor representation of the various people of Nigeria and narrow age range. [3],[4] A large scale study involving a large number of Nigerian children from a wide age range would be ideal to develop normative/reference ECG values for normal Nigerian children. Thus, the study conducted in Ilorin on 1500 Nigerian children aged 0-12 years in this journal issue is a welcome development. With the large sample size, the ECG generated with a sampling frequency of 1000 Hz, it could serve as the Nigerian reference values. It is particularly important that the neonatal age group be represented, as neonatal ECG could be difficult to interpret. The authors generated percentile curves. These make the diagnosis of certain conditions, such as LVH and RVH, in children using the criterion of amplitudes of S or R waves > 98 th percentile easy since there would now be reference values for the age and sex of the patients. They have also created normative heart rate values for the various pediatric ages. The heart rate generated by the ECG is one of the most reliable. Although it is desirable to have had an age range extending into 16 or 18 years, the authors did not study children older than 12 years of age. Another limitation to this study is the lack of representation of Nigerians from other parts of the country. Perhaps similar studies conducted in other parts of the country will ascertain if there are differences in ECG between the different peoples of Nigeria.

This study however represents a significant achievement in pediatric cardiology in Nigeria since ECG is perhaps the cheapest and most available tool for evaluating cardiovascular disease in most of our health facilities especially the ones in the periphery.

 
  References Top

1.Fye WB. A history of the origin, evolution, and impact of electrocardiography. Am J Cardiol 1994;73:937-49.  Back to cited text no. 1
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2.Macfarlane PW, McLaughlin SC, Devine B, Yang TF. Effect of age, sex, and race on ECG interval measurements. J Electrocardiol 1994;27 Suppl:14-9.  Back to cited text no. 2
    
3.Ifere OA. Heart rate, cardiac arrhythmia in normal infants and children. Trop Cardiol 1991;17:61-5.  Back to cited text no. 3
    
4.Edemeka DB, Ojo GO. Electrocardiogram in normal Nigerian Children. Saudi Heart J 1996;7:44-8.  Back to cited text no. 4
    




 

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