Abstract 12675: Novel Electrocardiographic Screening Criteria for Hypertrophic Cardiomyopathy in Children
BACKGROUND Many in the community have advocated screening school age children for silent cardiac disease using electrocardiography (ECG). Given that hypertrophic cardiomyopathy (HCM) is the leading cause of sudden death in young athletes, it seems logical to devise screening guidelines that most effectively identify this disorder.
HYPOTHESIS We sought to establish a convenient ECG screening tool to identify children with HCM. We hypothesized that the utilization of our pediatric-specific ECG criteria would perform better (higher receiver-operator curve (ROC)) than current popular criteria for screening children for silent heart disease.
METHODS The earliest available ECG for children (n=63) with HCM (ages 8 - 21 yrs) was reviewed. HCM was confirmed by echocardiography to determine accuracy of screening utilizing Sokolow-Lyon criteria (SV1+RV5/RV6; >35 mm), Cornell criteria (RaVL+SV2 >28 mm in males, 20 mm in females), and our modified criteria (RaVL+SV3>22 mm in males, 18 mm in females). The same criteria were applied to a cohort of age-matched and gender-matched controls.
RESULTS Statistically significant correlations were found between children with HCM and positive screen using Sokolow-Lyon, Cornell criteria and our modified criteria (p<0.01, for all). However comparison of ROC demonstrated an area under the curve (AUC) for males of 0.73 for Cornell criteria and an AUC of 0.84 for our modified criteria (Figure 1). From our cohort, the sensitivity for Cornell criteria is 36%, while the sensitivity for our criteria is 70%.
CONCLUSION Accurate screening in the pediatric population requires a tool that is specific for HCM. Our study demonstrates that pediatric specific criteria employing leads RaVL+SV3 is more accurate in identifying children with HCM in comparison to other commonly used screening criteria.
- © 2012 by American Heart Association, Inc.