title: Characterization of the electrocardiographic pattern of individuals with cerebral palsy.
abstract: BACKGROUND
  Dentists of Lar São Francisco observed during dental treatment that children with cerebral palsy (CP) had increased heart rate (HR) and lower production of saliva. Despite the high prevalence of CP found in the literature (2.08-3.6/1000 individuals), little is known about the electrocardiographic (ECG) characteristics, especially HR, of individuals with CP.
  
  
  OBJECTIVE
  This study aimed to investigate the hypothesis that individuals with CP have a higher HR and to define other ECG characteristics of this population.
  
  
  METHODS
  Ninety children with CP underwent clinical examination and 12-lead rest ECG. Electrocardiographic data on rhythm, HR, PR interval, QRS duration, P/QRS/T axis, and QT, QTc and T(peak-end) intervals (minimum, mean, maximum, and dispersion) were measured and analyzed then compared with data from a control group with 35 normal children. Fisher and Mann-Whitney U tests were used, respectively, to compare categorical and continuous data.
  
  
  RESULTS
  Groups cerebral palsy and control did not significantly differ in age (9 ± 3 × 9 ± 4 years) and male gender (65% × 49%). Children with CP had a higher HR (104.0 ± 20.6 × 84.2 ± 13.3 beats per minute; P < .0001), shorter PR interval (128.8 ± 15.0 × 138.1 ± 15.1 milliseconds; P = .0018), shorter QRS duration (77.4 ± 8.6 × 82.0 ± 8.7 milliseconds; P = .0180), QRS axis (46.0° ± 26.3° × 59.7° ± 24.8°; P = .0024) and T-wave axis (34.3° ± 28.9° × 42.9° ± 17.1°; P = .034) more horizontally positioned, and greater mean QTc (418.1 ± 18.4 × 408.5 ± 19.4 milliseconds; P = .0110). All the electrocardiogram variables were within the reference range for the age group including those with significant differences.
  
  
  CONCLUSIONS
  Children with CP showed increased HR and other abnormal ECG findings in the setting of this investigation. Further studies are needed to explain our findings and to correlate the increased HR with situations such as dehydration, stress, and autonomic nervous disorders.
authors.affiliation: Heart Institute (InCor)-Hospital das Clínicas-Faculdade de Medicina da Universidade de São Paulo, Brazil. ecg_pastore@incor.usp.br
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Pastore
authors.forename: Nelson
authors.initials: N
authors.lastname: Samesima
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Imada
authors.forename: Marta
authors.initials: M
authors.lastname: Reis
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Santos
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Ferreira
authors.forename: Cesar
authors.initials: C
authors.lastname: Grupi
authors.forename: Fernanda
authors.initials: F
authors.lastname: Fumagalli
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Wagenfuhr
authors.forename: Maira
authors.initials: M
authors.lastname: Chammas
mesh_terms: D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D001938:Brazil / Q000453:epidemiology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity