Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

Grażyna Markiewicz-Łoskot, Ewelina Kolarczyk, Bogusław Mazurek, Marianna Łoskot and Lesław Szydłowski
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Grażyna Markiewicz-Łoskot: Department of Nursing and Social Medical Problems, Faculty of Health Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
Ewelina Kolarczyk: Department of Propaedeutics of Nursing, Faculty of Health Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
Bogusław Mazurek: Department of Pediatric Cardiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
Marianna Łoskot: Students’ Research Group, Department of Nursing and Social Medical Problems, Faculty of Health Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
Lesław Szydłowski: Department of Pediatric Cardiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland

IJERPH, 2020, vol. 17, issue 18, 1-14

Abstract: The head-up tilt table test (HUTT) with the upright phase is used to help determine an imbalance of the sympathetic nervous system that is related to abnormal electrocardiographic repolarization in children with vasovagal syncope (VVS) and also in patients with the long QT syndrome (LQTS). The study attempted to evaluate T wave morphology and QT and TpTe (Tpeak–Tend) intervals recorded in ECG during the HUTT for a more accurate diagnosis of children with VVS. The group investigated 70 children with a negative HUTT result: 40 patients with VVS and 30 healthy volunteers without syncope. The RR interval as well as TpTe, and QTc intervals were measured in lead V5 of electrocardiogram (ECG) on admission to the hospital and during three phases of the HUTT. In syncopal children, which included 23 children with bifid or flat T waves and 17 patients with normal T waves in the upright phase, the QTc and TpTe were longer ( p < 0.001) compared to the other test phases and longer ( p < 0.001) than in the control group, respectively, with the risk of arrhythmias. Only in the control group, the TpTe was shorter ( p < 0.001) in the upright phase than in the other tilt phases. The TpTe in the upright phase (>70 ms) was a good discriminator, and was better than the QTc (>427 ms). Prolongation of electrocardiographic TpTe and QT intervals, in addition to the (abnormal T wave morphology recorded during the HUTT, are helpful for identifying VVS children more predisposed to ventricular arrhythmias with a latent risk of LQTS. Further studies are required to assess the value of these repolarization parameters in clinical practice.

Keywords: children; vasovagal syncope; long QT syndrome; head-up tilt-table test; electrocardiography; repolarization parameters; QTc and TpTe intervals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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