Korean J Pediatr.  2016 Nov;59(11):451-455. 10.3345/kjp.2016.59.11.451.

P wave dispersion on 12-lead electrocardiography in adolescents with neurocardiogenic syncope

Affiliations
  • 1Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea. ejcheon000@kyuh.ac.kr
  • 2Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea.

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±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±19.6 msec vs. 45.5±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±16.8 msec vs. 53.5±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.

Keyword

P wave dispersion; Neurocardiogenic syncope; Autonomic dysregulation

MeSH Terms

Adolescent*
Child
Echocardiography
Electrocardiography*
Female
Humans
Syncope
Syncope, Vasovagal*
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