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ORIGINAL ARTICLE
Korean J Pediatr 2014 April;57(4) :193-198.
Published online 2013 October 25.       
Baseline heart rate variability in children and adolescents with vasovagal syncope
Sun Hee Shim1, Sun-Young Park2, Se Na Moon3, Jin Hee Oh4, Jae Young Lee5, Hyun Hee Kim2, Ji Whan Han6, Soon Ju Lee2
1Department of Pediatrics, The Catholic University of Korea, Bucheon St. Marys Hospital, Bucheon, Korea
2Department of Pediatrics, The Catholic University of Korea, Yeouido St. Marys Hospital, Seoul, Korea
3Department of Pediatrics, The Catholic University of Korea, St. Pauls Hospital, Seoul, Korea
4Department of Pediatrics, The Catholic University of Korea, St. Vincents Hospital, Suwon, Korea
5Department of Pediatrics, The Catholic University of Korea, Seoul St. Marys Hospital, Seoul, Korea
6Department of Pediatrics, The Catholic University of Korea, Uijeongbu St. Marys Hospital, Uijeongbu, Korea
Corresponding Author: Soon Ju Lee ,Tel: +82-2-3779-1207, Fax: +82-2-783-2589, Email: soonju.lee@catholic.ac.kr
Copyright © 2014 by The Korean Pediatric Society
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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