Characteristics, Clinical Manifestation and Frequency of Early Repolarization Pattern in Children

The clinical features of early repolarization in children are important to prevent cardiac complications and sudden death. The aim of this study was to investigate the characteristics, clinical manifestations and frequency of early repolarization and the frequency of ventricular and atrial arrhythmias in children.

The present retrospective, cross-sectional study took in to account the files of 78 children between the ages of 5 and 18 with atrial or ventricular arrhythmia. Based on the ST segment pattern, the early repolarization was divided into malignant and benign categories, and according to the involvement of the lower and lateral leads, it was divided into three categories of low, medium and high risk.

Among the 78 investigated cases, the frequency of early repolarization was 21.8% (95% CI: 13-32) and 56.25% of the patients were in the benign group. Around 75% of the children with early repolarization had clinical symptoms, the most common symptom being palpitations (12.78%). The most common arrhythmias were ventricular tachycardia and ventricular fibrillation amounted to 87.21% and 25.6%. The most common arrhythmias with atrial origin were supraventricular tachycardia (50%), atrial flutter (37.9%), atrial tachycardia (25.6 %) and atrial fibrillation (12.3%) respectively. There was a significant relationship between the type of arrhythmias and repolarization.

The presence of early repolarization in children's ECG should be taken into consideration for the occurrence of atrial and ventricular arrhythmias. Also, in patients with palpitations, it can be important to check early repolarization even with a benign pattern.