New normal limits for pediatric ECG in childhood obesity? Influence of childhood obesity on the ECG

Abstract

IntroductionStudies demonstrated abnormal ECG phenomena in adult obese patients. Although some of these phenomena are clearly pathologic, for others the clinical relevance is less clear. In children this conflict is even harder to address as there are only scarce specific reference data on ECG in childhood obesity.The aim of this study was to investigate the influence of childhood obesity on distinct ECG parameters of cardiac activation and repolarization in a cohort of otherwise healthy obese volunteers and compare these with lean controls. MethodsWe prospectively enrolled 53 otherwise healthy obese children (BMI (mean/SD) 2.35 (1.39–3.56)) and 43 lean controls (BMI (mean/SD) −0.243 (−2.02–1.25)) from the LIFE Child Study. All probands underwent a thorough cardiac evaluation including a 12‑lead ECG. ResultsObese children showed a more left sided QRS axis (p<0.01). This effect was independent from age (p=0.28) or sex (p=0.3). Otherwise there were no major differences between the groups. Most importantly, there were no pathologic phenomena recorded in otherwise healthy, obese children. ConclusionIn healthy children, obesity does not result in pathologic ECG phenomena. Therefore pathology has only to be suspected in case of clearly abnormal ECG findings even in severely obese children.