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http://dx.doi.org/10.3345/kjp.2014.57.4.193

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)
Publication Information
Clinical and Experimental Pediatrics / v.57, no.4, 2014 , pp. 193-198 More about this Journal
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.
Keywords
Vasovagal syncope; Heart rate; Child; Adolescent;
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