Interpretation of Pediatric Electrocardiogram (ECG)

Normal Pediatric ECG Characteristics

Pediatric electrocardiography (ECG) is an essential tool for assessing the electrical activity of a child's heart. Understanding normal ECG characteristics in pediatrics helps differentiate physiological variations from pathological findings.

Age-Based Differences in Pediatric ECG

Neonates & Infants

• Higher heart rates (average 120-160 bpm).
• Right ventricular dominance due to fetal circulation adaptations.
• Shorter PR and QT intervals compared to adults.

Children & Adolescents

• Gradual shift to left ventricular dominance.
• Heart rate decreases progressively (80-120 bpm).
• More defined P waves and QRS complexes.

Key ECG Parameters in Pediatrics

Heart Rate & Rhythm

Normal pediatric heart rates vary significantly by age, decreasing as the child grows. Sinus arrhythmia is a common finding in children.

P Wave & PR Interval

P waves are smaller but visible, and PR intervals are shorter in younger children.

QRS Complex

Right ventricular dominance in neonates leads to a rightward QRS axis, which normalizes with age.

ST Segment & T Wave

Inversion of T waves in precordial leads (V1-V3) is normal in young children.

Conclusion

Recognizing normal variations in pediatric ECG prevents misdiagnosis and ensures accurate cardiac assessments. Pediatric ECG interpretation requires age-specific knowledge to distinguish physiological from pathological findings.