Cardiac Conduction Disturbance Detected in a Pediatric Population

Chiu, Shuenn-Nan; Wang, Jou-Kou; Wu, Mei-Hwan; Chang, Chi-Wei; Chen, Chun-An; Lin, Ming-Tai; Wu, En-Ting; Hua, Yu Chuan; Lue, Hung-Chi; Taipei Pediatric Cardiology Working Group,

doi:10.1016/j.jpeds.2007.05.044

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Volume 152, Issue 1 , Pages 85-89, January 2008

Cardiac Conduction Disturbance Detected in a Pediatric Population

Shuenn-Nan Chiu, MD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
Jou-Kou Wang, MD, PhD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
Mei-Hwan Wu, MD, PhD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
- Reprint requests: Mei-Hwan Wu, MD, Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shen South Road, Taipei, Taiwan 100.
Chi-Wei Chang, MD
- Department of Pediatrics, En Chu Kong Hospital, Taipei, Taiwan.
Chun-An Chen, MD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
Ming-Tai Lin, MD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
En-Ting Wu, MD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
Yu Chuan Hua, BS
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
Hung-Chi Lue, MD, PhD
- Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
Taipei Pediatric Cardiology Working Group

Received 25 December 2006; received in revised form 12 March 2007; accepted 25 May 2007. published online 25 October 2007.

Objective

To delineate the prevalence and clinical implications of cardiac conduction disturbance (CCD) in school-age children.

Study design

Between 1999 and 2001, a citywide survey of 432,166 elementary and high school students had been performed in Taipei by questionnaire, electrocardiography, phonocardiography, and physical examination. Patients with any abnormalities on this survey were referred for final diagnosis.

Results

After excluding those with congenital heart disease (CHD), the prevalence of CCD was 0.75%, higher in males than in females (0.78% vs 0.71%). Incomplete right bundle branch block (IRBBB; 0.32%), complete right bundle branch block (CRBBB; 0.11%), ventricular premature contraction (0.11%), and Wolff-Parkinson-White syndrome (0.067 %) were the most common diagnoses. Second-degree atrioventricular block, IRBBB, CRBBB, and intraventricular conduction delay were more common in males; and atrial premature contraction was more common in females. The prevalence of CCD increased with age, from 0.48% in elementary school students to 0.97% in high school students. After detection of CCD, 39 patients with previously undiagnosed atrial septal defect (ASD) and 15 high-risk patients were found. The sensitivity of IRBBB in screening for ASD was 34.67%.

Conclusions

The prevalence of CCD in children without CHD was 0.75%. Detection of CCD helped identify patients with unrecognized ASD and high-risk cardiac patients.

Abbreviations: APC, Atrial premature contraction, ASD, Atrial septal defect, AVB, Atrioventricular block, CCD, Cardiac conduction disturbance, CHD, Congenital heart disease, CRBBB, Complete right bundle branch block, EKG, Electrocardiography, IRBBB, Incomplete right bundle branch block, IVCD, Intraventricular conduction delay, OR, Odds ratio, VPC, Ventricular premature contraction, WPW, Wolff-Parkinson-White syndrome