Key result
Population ECG screening reveals abnormalities in ~3% of school children, most commonly long QTc intervals.
Why the study?
ECG screening may enable early detection and preventive therapy for conditions elevating the risk of sudden cardiac death in children, but the prevalence and characteristics of ECG abnormalities in this population needed assessment.
Does 12-lead ECG screening detect conditions associated with the risk of sudden cardiac death in elementary school children?
Cross-Sectional (n=14,403)
Yes
Does 12-lead ECG screening detect conditions associated with the risk of sudden cardiac death in elementary school children?
Population-based 12-lead ECG screening in school children identified abnormal findings in 3.3% of students, most commonly prolonged QTc intervals, highlighting its potential for early detection of sudden cardiac death risk factors.
Highlights potential ECG screening yield in school-aged children; leaves open whether detection improves outcomes or justifies population-wide programs.
BACKGROUND: Identification of life-threatening arrhythmogenic disorders, which may present during infancy, childhood, or later stages, enables the early initiation of effective preventive therapies. Electrocardiogram (ECG) screening may detect conditions that elevate risk of sudden cardiac death (SCD) at an early stage. OBJECTIVES: This study aims to assess the prevalence, clinical significance, and characteristics of ECG abnormalities in a large population of schoolchildren. It also aims to determine whether ECGs performed during childhood can aid in the early detection of conditions associated with the risk of SCD. DESIGN: Population-based cross-sectional study. SETTING: A multicenter study conducted at King Faisal Specialist Hospital & Research Centre (KFSHRC) in Riyadh and Prince Sultan Cardiac Center-Qassim (PSCC-Q), Qassim, Saudi Arabia. METHODS: The study analyzed 12-lead ECGs performed on elementary school students 6-15 years old in Buraidah, Qassim region, Saudi Arabia. ECGs were recorded and interpreted following international standards. Children with abnormal ECG results were referred for full pediatric cardiology evaluation. MAIN OUTCOME MEASURES: Prevalence of normal and abnormal ECG findings, including long QT intervals. SAMPLE SIZE: 14 403 students. RESULTS: During the study period, ECGs were performed on 14 403 students (53.8% females). The mean age was 9.5±1.9 years, and the mean weight was 32.1±16.1 kg. Abnormal ECGs were identified in 468 students (3.3%), 271 of whom had complete clinical evaluation, including repeat ECG and echocardiography. The most common ECG abnormality was a prolonged QTc interval. The overall prevalence of abnormal ECG findings ranged from 0.7% to 2.04%, with long QTc intervals (460 msec or more) found in 0.4% to 1.6% of students. CONCLUSIONS: Long QTc intervals (460 msec or more) were the most common ECG abnormality in school children, with an estimated prevalence of 0.4% to 1.6%. This study may serve as a model for large-scale, community-based, 12-lead ECG screening programs for children. LIMITATIONS: Causality cannot be derived given the design, the potential for false positive and false-negative results, and the lack of genetic studies for children with prolonged QT intervals.
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Alakhfash et al. (2025) conducted a cross-sectional in Electrocardiogram abnormalities (n=14,403). 12-lead ECG screening was evaluated on Prevalence of abnormal ECG findings. In a population-based screening of 14,403 school children, abnormal ECGs were identified in 3.3% of students, with long QTc intervals being the most common abnormality at an estimated prevalence of 0.4% to 1.6%.
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