Prevalence of subtle cardiac electrical abnormalities in children with idiopathic scoliosis

We aimed to assess the prevalence of ECG abnomialities in children with idiopathic scoliosis (IS). 77 girls and 13 boys, aged 7 to 18 years (15 3), including 12 with thoracic scoliosis (mean Cobbe angle 33 degrees), 4 with lumbar scoliosis (29 degrees), 12 with thoracolumbar (27 degrees), and 62 with double-major scoliosis (31 degrees) entered the study. They were grouped as follows: 20 children < 14 years of age (A), 35 from 14 to 16 (B), and 35 > 16 years of age (C). Routine ECG was recorded and analysed automatically (GE, CASE v.4.1). Several ECG indices were further analysed. Abnormal values were considered if they exceeded upper normal limit (> 95 percentile). Results. Abnormalities were found in 66 patients (73%) independent of age. QRS duration > 90ms was observed in 40 patients (44%), right axis deviation in 28 (31%), left axis deviation in 2 (2%). The Rsr(V1-2) pattern was noticed in 25 patients (28%). Ventricular gradient > 60 degrees was found in 11 patients (12%). In patients with normal ECG there was a normal leftward axis rotation with age (10 degrees +/- 18 degrees in gr.A, -5 degrees +/- 7 degrees in gr.13 and +2 degrees +/- 22 degrees in gr.C, difference from median), whereas reversed trend (rightward deviation with age) characterized patients with ECG abnormalities (-7 degrees +/- 30 degrees in gr.A, +9 degrees +/- 19 degrees in gr.B and +19 degrees +/- 2 degrees in gr.C, P < 0.001). Conclusion. In children with idiopathic scoliosis, subtle ECG abnormalities are frequent. Abnormal trend of rightward QRS axis deviation with age suggests cardiac involvement in natural history of scoliosis and requires more depth cardiac evaluation.