{"id":1415,"date":"2015-06-12T17:36:53","date_gmt":"2015-06-12T17:36:53","guid":{"rendered":"http:\/\/library.sath.nhs.uk\/intelligence\/?p=1415"},"modified":"2016-10-31T13:25:35","modified_gmt":"2016-10-31T13:25:35","slug":"effect-of-hyperventilation-on-rate-corrected-qt-interval-of-children-2013","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2015\/06\/12\/effect-of-hyperventilation-on-rate-corrected-qt-interval-of-children-2013\/","title":{"rendered":"Effect of hyperventilation on rate corrected QT interval of children (2013)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nJournal article<\/p>\n<p><strong>Author(s):<\/strong><br \/>\n*A Kannivelu, V Kudumula, V Bhole<\/p>\n<p><strong>Citation:<\/strong><br \/>\nArchives of Disease in Childhood. 2013 Feb;98(2):103-6<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nBACKGROUND: Hyperventilation is known to cause ST segment changes and QT variability in adults, but this has not been systematically studied in children.<br \/>\nAIM: To investigate the effect of hyperventilation on rate corrected QT interval (QTc) in children.<br \/>\nMETHODS AND RESULTS: 25 children (male=10) with a median age of 14 (range 8.3-17.6) years were asked to hyperventilate for 1 min before exercise testing using the modified Bruce protocol. Mean QTc at rest, after hyperventilation, at peak exercise and at 1 min of recovery was 425(\u00b131), 460(\u00b130), 446(\u00b138) and 420(\u00b132) ms, respectively. Mean increase (95% CI) in QTc after hyperventilation was 35(19 to 51) ms (p&lt;0.001), while there was minimal difference between QT interval at rest and after hyperventilation (mean QT 352(\u00b141) vs 357(\u00b144) ms). In six children, there were abnormalities in T wave morphology following hyperventilation. The QTc increment following hyperventilation was more pronounced in children with resting QTc &lt;440 ms (n=14, mean increment (95% CI): 55 (33 to 78) ms) compared to children with QTc \u2265440 ms (n=11, mean increment (95% CI): 9 (-4 to 22) ms) (p=0.001). QTc prolongation following hyperventilation was seen in children with both low and intermediate probability of long QT syndrome (LQTS). Peak exercise and early recovery did not cause a statistically significant change in QTc in either of these groups.<br \/>\nCONCLUSIONS: Hyperventilation produces repolarisation abnormalities, including prolongation of QTc and T wave abnormalities in children with low probability of LQTS. The likely mechanism is delayed adaptation of QT interval with increased heart rate. Thus, a hyperventilation episode can be misdiagnosed as LQTS, especially in an emergency department.<\/p>\n<p><strong>Link to more details or full-text: <\/strong><a href=\"http:\/\/adc.bmj.com\/content\/early\/2012\/12\/13\/archdischild-2012-302663.full.pdf\">http:\/\/adc.bmj.com\/content\/early\/2012\/12\/13\/archdischild-2012-302663.full.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): *A Kannivelu, V Kudumula, V Bhole Citation: Archives of Disease in Childhood. 2013 Feb;98(2):103-6 Abstract: BACKGROUND: Hyperventilation is known to cause ST segment changes and QT variability in adults, but this has not been<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2015\/06\/12\/effect-of-hyperventilation-on-rate-corrected-qt-interval-of-children-2013\/\">Read more <span class=\"screen-reader-text\">Effect of hyperventilation on rate corrected QT interval of children (2013)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[200],"tags":[442,441,443,438,439,440],"class_list":["post-1415","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-adolescents","tag-children","tag-exercise-test","tag-hyperventilation","tag-long-qt-syndrome","tag-lqtc"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/1415","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=1415"}],"version-history":[{"count":1,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/1415\/revisions"}],"predecessor-version":[{"id":1424,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/1415\/revisions\/1424"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=1415"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=1415"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=1415"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}