Pediatric Electrocardiogram (ECG): Current Status and Further Perspectives

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 549

Special Issue Editor


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Guest Editor
5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
Interests: catheter ablation; supraventricular tachycardia; atrial fibrillation; heart failure; ventricular tachycardia; pacemaker implantation; statistics

Special Issue Information

Dear Colleagues,

We are delighted to present this captivating Special Issue focused on the Pediatric ECG. The hearts of children undergo rapid development during early life, necessitating specific interpretation of electrocardiograms dependent on physiological factors such as size, conduction speed, and waveform amplitudes.

Age-related differences observed in pediatric and adolescent electrocardiograms involve heart rate, P and QRS axes, PR and QT intervals, and ECG voltage criteria. Age- and sex-based reference ranges enable clinicians to differentiate between normal physiological variation and pathological anomalies. Knowledge of common arrhythmias in children is necessary for ECG monitoring in pediatric patients, which may be different from those of adolescents or adults.

Several arrhythmias that are deemed pathological in adults may be considered normal in children. Healthy children may exhibit respiratory and non-respiratory sinus arrhythmia, as well as low atrial rhythm and junctional rhythm; these are considered normal for a child.

Clinicians and scientists are encouraged to contribute their research on the following topics:

  1. The size and developmental stage of the child affects the placement of ECG leads and pediatric ECG;
  2. Cardiac anatomy in congenotal heart disease and its impact on the ECG signals;
  3. Recent advancements in ECG technology;
  4. Use of artificial intelligence for electrocardiogram interpretation;
  5. Pediatric physiological arrhythmias;
  6. Abnormal electrocardiogram patterns in pediatric patients.

Overall, we are certain that the materials published in this Special Issue will significantly enhance our existing understanding of pediatric electrocardiography. We wish to extend our appreciation to all authors for their expected contribution and anticipate that all readers will find this cutting-edge Special Issue enjoyable.

Dr. Gabriel Cismaru
Guest Editor

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Keywords

  • pediatric ECG
  • arrhythmia detection
  • congenital heart disease
  • technological innovations
  • clinical challenges
  • personalized medicine

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Published Papers (1 paper)

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Research

19 pages, 3594 KiB  
Article
ECG Evolution in Elite Gymnasts: A Retrospective Analysis of Training Adaptations, Risk Prediction, and PPE Optimization
by Alina Maria Smaranda, Adela Caramoci, Teodora Simina Drăgoiu and Ioana Anca Bădărău
Diagnostics 2025, 15(8), 1007; https://doi.org/10.3390/diagnostics15081007 - 15 Apr 2025
Viewed by 254
Abstract
Background: Electrocardiographic (ECG) screening is crucial in pre-participation evaluations (PPEs) for elite athletes, aiding in the early detection of cardiac adaptations and potential risks. Elite female gymnasts experience unique cardiovascular adaptations due to intensive training, yet limited longitudinal data exist on their ECG [...] Read more.
Background: Electrocardiographic (ECG) screening is crucial in pre-participation evaluations (PPEs) for elite athletes, aiding in the early detection of cardiac adaptations and potential risks. Elite female gymnasts experience unique cardiovascular adaptations due to intensive training, yet limited longitudinal data exist on their ECG evolution. This study introduces Oracle Crystal Ball, a predictive tool for forecasting ECG abnormalities and assessing PPE cost-effectiveness to optimize screening protocols. Methods: This retrospective cohort study analyzed ECG and cardiovascular parameters in twelve elite female gymnasts who underwent up to 14 PPEs over several years at the National Institute of Sports Medicine, Romania. Longitudinal ECG trends, training variables, and biochemical markers were examined using statistical analyses, including logistic regression, repeated measures ANOVA, and time-series forecasting (ARIMA). Monte Carlo simulations assessed the cost-effectiveness of 6-month vs. 12-month PPE schedules. Results: The athletes exhibited significant cardiovascular adaptations, including progressive declines in resting heart rate and training-induced ECG changes. Junctional escape rhythms and T-wave inversions (V1–V3) increased with age, requiring refined ECG interpretation. Predictive modeling demonstrated the feasibility of individualized risk stratification, while a cost-effectiveness analysis revealed that a 12-month PPE schedule was financially advantageous without reducing diagnostic accuracy. Conclusions: Longitudinal ECG monitoring and predictive analytics improve risk assessment in elite gymnasts. Oracle Crystal Ball enhances athlete-specific screening, minimizing unnecessary tests while ensuring early detection of clinically significant ECG changes. A 12-month PPE schedule is a cost-effective alternative for elite athletes. Full article
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