Key result
Short-term heart rate asymmetry occurs in ~94% of healthy children on 24-hour ECG.
Why the study?
Heart rate asymmetry has been demonstrated in adult ECGs, but a similar investigation in healthy children had not been conducted.
Cross-Sectional (n=96)
This study establishes that physiological heart rate asymmetry and its compensation are common phenomena on 24-hour ECGs in healthy children, providing normal reference data for pediatric populations.
Provides normative HRA values on 24-hour ECGs in healthy children; leaves open diagnostic or prognostic utility in disease.
Heart rate asymmetry (HRA) is a physiological phenomenon characterized by an unequal contribution of heart rate decelerations and accelerations to different heart rate variability (HRV) features. While HRA has been demonstrated in adults' ECGs of different duration, a similar investigation in healthy children has not been conducted. This study investigated the variance- and number-based HRA features in 96 healthy children (50 girls and 46 boys, aged 3-18 years) using 24-h ECGs. Additionally, we studied sex differences in HRA. To quantify HRA, variance-based and relative contributions of heart rate decelerations to short-term (C1d), long-term (C2d), and total (CTd) HRV, and the number of all heartbeats (Nd) were computed. Heart rate decelerations contributed more to C1d, but less to C2d and CTd, and were less frequent than heart rate accelerations. Short-term HRA was better expressed in boys. The majority of children (93.7%) had short-term HRA, 88.5% had long-term HRA, 88.5% had total HRA, and 99.0% had more accelerations than decelerations. No sex differences were observed for the rate of various HRA features. Heart rate asymmetry is a common phenomenon in healthy children, as observed in 24-h ECGs. Our findings can be used as reference data for future clinical studies on HRA in children.
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Zalas et al. (2023) conducted a cross-sectional in Healthy (n=96). 24-h Holter ECG monitoring was evaluated on Presence of short-term heart rate asymmetry (C1d > 0.5). Heart rate asymmetry is a common phenomenon in healthy children, with 93.7% exhibiting short-term asymmetry and 88.5% exhibiting long-term and total asymmetry on 24-hour ECGs.
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