Assessment of the age range, where juvenile T inversion pattern in right precordial leads of an ECG changes to the adult upright T wave pattern

Objective: To determine the age range, where juvenile T inversion pattern in right precordial leads (V1 to V4) in an ECG changes to the adult upright T wave pattern

Method: A descriptive cross-sectional study was done in children aged 5 years and above referred to the paediatric cardiology clinic, Teaching Hospital Karapitiya from January 2012 to April 2013. Inclusion criteria were: children with no cardiac lesion or a haemodynamically insignificant cardiac lesion after a full cardiac evaluation.The cohort was divided into six age groups and the presence of juvenile and adult ECG patterns were evaluated.

Results: A total number of 1039 children were enrolled. At the age of 13 years 50% depicted both juvenile and adult ECG patterns. At the age range of 13-15 years 78 (60%) of a total of 130 showed the adult ECG pattern compared to 99 (44.4%) of a total of 223 at 11-13 years (X²=8.0; p=0.005). Even after 13 years of age the juvenile ECG pattern persisted in 30-40% of children.

Conclusions: Transition of the juvenile T inversion pattern in right precordial leads in an ECG to the adult upright T wave pattern occurs predominantly at the age range of 13-15 years. Presence of juvenile T inversion pattern in an ECG after 13-15 years can be a normal finding as well as may be a pre-symptomatic diagnosis of a cardiomyopathy. Although it is normal to have a juvenile ECG pattern above 13 years it is advisable to perform an echocardiographic evaluation on children above 13 years with juvenile T inversion pattern  which may lead to early diagnosis of cardiomyopathy.

Sri Lanka Journal of Child Health, 2013; 42: 205-208

(Key words: Juvenile T inversion pattern; Adult upright T wave pattern; ECG)

DOI: http://dx.doi.org/10.4038/sljch.v42i4.6264