The Comparison of Pediatric Electrocardiograph in Upright and Supine position

Authors

  • อุเทน บุญมี

DOI:

https://doi.org/10.14456/jmu.2019.12

Abstract

          The supine position was a standard position to perform electrocardiogram (ECG). In young children, especially under 5 years old, it was difficult to perform ECG on the standard position. In previous studies, most studies were done in adult patients and focus on the change of QTc duration. We proposed that the upright position was easier to perform ECG. Thus, this was a retrospective study comparing the duration and voltage change in pediatric ECG between supine and upright positions in three-to-eleven-year Thai children. The ECGs were done in both positions within 30 minutes by the technician and nurse. Paired T-Test was used to compare ECG in both positions. All 240 leads (12 leads in each position per person) on ECG were measured for P duration, PR interval, P voltage, QRS duration, QRS voltage, QT interval, T duration, and T voltage. For the result, chest leads QRS voltage in supine position had 0.3 mV statistical significant higher than in upright position (P value < 0.05). In conclusion, using QRS voltage, such as ventricular hypertrophy, in upright position was needed to be carefully interpret.

References

1. Baevsky, R. H., Haber, M. D., Blank, F. S., & Smithline, H. J. T. A. j. o. e. m. (2007). Supine vs semirecumbent and upright 12-lead electrocardiogram: does change in body position alter the electrocardiographic interpretation for ischemia? , 25(7), 753-756.

2. DAVEY, P. J. C. S. (1999). Influence of posture and handgrip on the QT interval in left ventricular hypertrophy and in chronic heart failure. 96(4), 403-407.

3. Eldridge, J., Richley, D., Baxter, S., Blackman, S., Breen, C., Brown, C.,Rees, E. (2014). Recording a standard 12-lead electrocardiogram. An approved methodology by the Society of Cardiological Science and Technology (SCST). Clinical guidelines by consensus.

4. Hancock, E. W., Deal, B. J., Mirvis, D. M., Okin, P., Kligfield, P., & Gettes, L. S. J. J. o. t. A. C. o. C. (2009). AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part V: electrocardiogram changes associated with cardiac chamber hypertrophy a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology. 53(11), 992-1002.

5. Khare, S., & Chawala, A. J. N. J. o. C. (2016). Effect of change in body position on resting electrocardiogram in young healthy adults. 13(2), 125.

6. Kubo, Y., Murakami, S., Otsuka, K., Shiga, T., Irie, S., & Kasanuki, H. J. J. o. A. (2005). Postural Change-associated Alterations in QT/QTc Intervals on Electrocardiograms. 21(5), 528-535.

7. Madias, J. E. J. J. o. e. (2006). Comparability of the standing and supine standard electrocardiograms and standing sitting and supine stress electrocardiograms. 39(2), 142-149.

8. Markendorf, S., Lüscher, T. F., Gerds-Li, J.-H., Schönrath, F., & Schmied, C. M. J. C. j. (2018). Clinical impact of repolarization changes in supine versus upright body position. 25(5), 589-594.

9. Rautaharju, P. M., Surawicz, B., & Gettes, L. S. J. J. o. t. A. C. o. C. (2009). AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology. 53(11), 982-991.

10. Surawicz, B., Childers, R., Deal, B. J., & Gettes, L. S. J. J. o. t. A. C. o. C. (2009). AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society endorsed by the International Society for Computerized Electrocardiology. 53(11), 976-981.

11. To, A., & Officer, A. J. M. (2010). Adult & Paediatric Resting Electrocardiography (ECG) Cardiac Sciences. 6.

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Published

2019-12-25

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Research Articles