title: Baseline heart rate variability in children and adolescents with vasovagal syncope.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Shim
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, St. Paul's Hospital, Seoul, Korea.
authors.forename: Se Na
authors.initials: SN
authors.lastname: Moon
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
authors.forename: Hyun Hee
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
authors.forename: Ji Whan
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
authors.forename: Soon Ju
authors.initials: SJ
authors.lastname: Lee
keywords: Adolescent; Child; Heart rate; Vasovagal syncope