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

• Lee DH
• Lee KM
• Yoon JM
• Lim JW
• Kho KO
• Kil HR
• Cheon EJ

• KMID: 2358026
• DOI: http://doi.org/10.3345/kjp.2016.59.11.451

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*