Congenital heart diseaseResearch article
Developmental trajectories of electrocardiographic parameters in pediatric patients
- retrospectively analyzed
Authors' conclusion
High-temporal-resolution ECG trajectories define age-specific norms in early life and enable the detection of disease-related deviations, particularly during the dynamic neonatal period.
Study context
- Population
- Pediatric patients at a large pediatric hospital with electrocardiographic (ECGs) adjudicated as normal by a pediatric cardiologist; patients with unrepaired tetralogy of Fallot for comparisonpatients at a large pediatric hospital
- Participants
- 6,967 patients
- Comparison
- z scores quantified deviations in developmental trajectories between the clinically cardiovascular diseases (CVD)-free cohort and patients with unrepaired tetralogy of Fallot
- patients with unrepaired tetralogy of Fallotn = 305
Main finding
As reported in the abstract
Developmental shifts in heart rate, QRS, PR, QT, and corrected QT
- All 5 ECG parameters demonstrated significant developmental shifts, with marked differences between early (1-8 days) and late neonates (9-35 days)
Further findings
Deviations in patients with unrepaired tetralogy of Fallot vs CVD-free children
- corrected QT outliers (|Z| > 2), early neonates
- 32.7%
- corrected QT outliers (|Z| > 2), late neonates
- 24.3%
- altered heart rate, PR, and QRS in late neonates
Sensitivity analysis ranking parameters by age dependence
- neonatal period identified as the most dynamic stage of electrophysiological maturation, followed by slower changes in infancy and childhood
Original publication
Developmental trajectories of electrocardiographic parameters in pediatric patients. Heart Rhythm. Published 14 August 2026. doi:10.1016/j.hrthm.2026.08.013
Summarised from the published abstract; every number is checked against it