Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Baseline heart rate variability in children and adolescents with vasovagal syncope

  • Shim, Sun Hee (Department of Pediatrics, The Catholic University of Korea, Bucheon St. Mary's Hospital) ;
  • Park, Sun-Young (Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital) ;
  • Moon, Se Na (Department of Pediatrics, The Catholic University of Korea, St. Paul's Hospital) ;
  • Oh, Jin Hee (Department of Pediatrics, The Catholic University of Korea, St. Vincent's Hospital) ;
  • Lee, Jae Young (Department of Pediatrics, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Kim, Hyun Hee (Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital) ;
  • Han, Ji Whan (Department of Pediatrics, The Catholic University of Korea, Uijeongbu St. Mary's Hospital) ;
  • Lee, Soon Ju (Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital)
  • Published : 2014.04.15
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Abstract

Purpose: This study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope. Methods: To characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups. The following time-domain indices were calculated: root mean square of the successive differences (RMSSD); standard deviation of all average R-R intervals (SDNN); and frequency domain indices including high frequency (HF), low frequency (LF), normalized high frequency, normalized low frequency, and low frequency to high frequency ratio (LF/HF). Results: HRV values were significantly different between healthy children and those with syncope. Student t test indicated significantly higher SNDD values (60.46 ms vs. 37.42 ms, P =0.003) and RMSSD (57.90 ms vs. 26.92 ms, P=0.000) in the patient group than in the control group. In the patient group, RMSSD (80.41 ms vs. 45.89 ms, P =0.015) and normalized HF (61.18 ms vs. 43.19 ms, P =0.022) were significantly higher in adolescents, whereas normalized LF (38.81 ms vs. 56.76 ms, P =0.022) and LF/HF ratio (0.76 vs. 1.89, P =0.041) were significantly lower in adolescents. In contrast, the control group did not have significant differences in HRV values between adolescents and preadolescents. Conclusion: The results of this study indicated that children with syncope had a decreased sympathetic tone and increased vagal tone compared to healthy children. Additionally, more severe autonomic imbalances possibly occur in adolescents than in preadolescents.

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