Das EKG von Kindern verändert sich fortlaufend mit dem Alter: Herzfrequenz, Lagetyp und Wellenmorphologie unterscheiden sich beim Neugeborenen stark von den Referenzwerten Erwachsener und normalisieren sich im Lauf des Wachstums schrittweise. Die Befundung erfolgt ebenso systematisch wie bei Erwachsenen, jedoch gegen die nachstehenden altersspezifischen Referenzwerte.
Befundungsmethode
- Herzfrequenz
- Herzrhythmus
- P-Welle
- PQ-Zeit
- QRS-Komplex
- ST-Strecke
- T-Welle
- U-Welle
- QT-Zeit (QTc-Zeit)
Neonatale Referenzwerte
Davignon et al. Die Bereiche sind 98-Prozent-Konfidenzintervalle, der Mittelwert steht in Klammern.
| Alter | <1 Tag | 1–3 Tage | 3–7 Tage | 7–30 Tage | 1–3 Mon. | 3–6 Mon. | 6–12 Mon. | 1–3 J. | 3–5 J. | 5–8 J. | 8–12 J. | 12–16 J. | >16 J. |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Herzfrequenz (Schläge/min) | 93–155 (122) | 91–158 (124) | 90–166 (128) | 106–182 (148) | 120–179 (149) | 105–185 (142) | 107–168 (132) | 90–151 (119) | 73–137 (108) | 65–133 (100) | 63–129 (92) | 66–120 (86) | 50 – 120 |
| Lagetyp (Grad) | 58–168 (>135) | 65–171 (>134) | 76–168 (>133) | 65–159 (110) | 31–115 (75) | 7–105 (60) | 7–98 (54) | 8–100 (55) | 7–104 (55) | 10–140 (66) | 9–115 (61) | 11–133 (58) | -15 – 110 |
| QRS-Dauer | 21–76 | 22–67 | 21–68 | 22–79 | 23–75 | 22–79 | 23–76 | 27–75 | 30–72 | 32–79 | 32–85 | 34–88 | 0.05 – 0.10 |
| PQ-Zeit | 79–160 (107) | 81–139 (108) | 75–137 (104) | 73–138 (101) | 73–130 (98) | 74–145 (106) | 73–156 (156) | 82–148 (114) | 85–161 (118) | 90–164 (124) | 87–171 (128) | 92–175 (135) | 0.12 – 0.20 |
| Q in III (mm) | 0.1–5 | 0.1–5 | 0.1–5 | 0.1–5 | 0.1–5 | <6.6 | <6.3 | <5.3 | <4.2 | <3.2 | <2.7 | <3.0 | <3 |
| R in V1 (mm) | 5–27 (14) | 5–27 (15) | 3–25 (13) | 3–22 (11) | 3–19 (10) | 3–20 (10) | 2–20 (9) | 3–18 (9) | 2–18 (8) | 1–13 (7) | 0.5–10 (6) | 0.5–10 (5) | 0.5 – 14 |
| S in V1 (mm) | 0.5–23 (9) | 0.5–21 (10) | 0.5–17 (7) | 0.5–12 (4) | 0.5–13 (5) | 0.5–17 (6) | 0.5–18 (7) | 1–21 (9) | 2–22 (10) | 3–24 (12) | 3–26 (12) | 3–22 (11) | 0.5 – 23 |
| R/S-Quotient in V1 | 0.2–9.8 (2.3) | 0.2–6.0 (2.0) | 0.2–9.8 (2.8) | 1.0–7.0 (2.9) | 0.3–7.5 (2.3) | 0.2–6.0 (2.4) | 0.1–3.9 (1.8) | 0.1–4.2 (1.4) | 0–2.8 (0.9) | 0–2.0 (0.8) | 0–1.9 (0.6) | 0–1.8 (0.5) | |
| R in V6 (mm) | 0–12 (5) | 0.1–12 (5) | 0.5–12 (5) | 3–17 (8) | 5–22 (12) | 6–23 (14) | 6–23 (13) | 6–23 (14) | 9–25 (15) | 9–27 (17) | 10–26 (17) | 7–23 (15) | 4 – 21 |
| S in V6 (mm) | 0.2–10 (4) | 0.2–10 (3) | 0.4–10 (4) | 0.2–10 (3) | 0.3–7 (3) | 0.2–10 (3) | 0.2–8 (2) | 0.1–7 (2) | 0.1–6 (2) | 0.1–4 (1) | 0.0–4 (1) | 0–4 (1) | 0 – 4 |
| R/S-Quotient in V6 | 0.5–9 (2.5) | 0.5–11 (3) | 0.5–10 (2.5) | 0.5–12 (4) | 0.5–12 (4.5) | 0.5–18 (6.5) | 0.5–22 (8) | 0.5–28 (9.5) | 0.8–30 (11) | 1–30 (12) | 2–33 (14) | 2–39 (15) |
Kinder, Übersicht
Rijnbeek et al. Medianwerte mit 2. und 98. Perzentile.
| 0–1 Mon. | 1–3 Mon. | 3–6 Mon. | 6–12 Mon. | 1–3 J. | 3–5 J. | 5–8 J. | 8–12 J. | 12–16 J. | ||
|---|---|---|---|---|---|---|---|---|---|---|
| Herzfrequenz (Schläge/min) | Jungen | 160 (129, 192) | 152 (126, 187) | 134 (112, 165) | 128 (106, 194) | 119 (97, 155) | 98 (73, 123) | 88 (62, 113) | 78 (55, 101) | 73 (48, 99) |
| Mädchen | 155 (136, 216) | 154 (126, 200) | 139 (122, 191) | 134 (106, 187) | 128 (95, 178) | 101 (78, 124) | 89 (68, 115) | 80 (58, 110) | 76 (54, 107) | |
| Lagetyp der P-Welle | Jungen | 56 (13, 99) | 52 (10, 73) | 49 (–5, 70) | 49 (9, 87) | 48 (–12, 78) | 43 (–13, 69) | 41 (–54, 72) | 39 (–17, 76) | 40 (–24, 76) |
| Mädchen | 52 (24, 80) | 48 (20, 77) | 51 (16, 80) | 50 (14, 69) | 47 (1, 90) | 44 (–6, 90) | 42 (–13, 77) | 42 (–15, 82) | 45 (–18, 77) | |
| P-Wellen-Dauer | Jungen | 78 (64, 85) | 79 (65, 98) | 81 (64, 103) | 80 (66, 96) | 80 (63, 113) | 87 (67, 102) | 92 (73, 108) | 98 (78, 117) | 100 (82, 118) |
| Mädchen | 79 (69, 106) | 78 (62, 105) | 78 (63, 106) | 80 (64, 07) | 83 (62, 104) | 84 (66, 101) | 89 (71, 107) | 94 (75, 114) | 98 (78, 122) | |
| PQ-Zeit (ms) | Jungen | 99 (77, 120) | 98 (85, 120) | 106 (87, 134) | 114 (82, 141) | 118 (86, 151) | 121 (98, 152) | 129 (99, 160) | 134 (105, 174) | 139 (107, 178) |
| Mädchen | 101 (91, 121) | 99 (78, 133) | 106 (84, 127) | 109 (88, 133) | 113 (78, 147) | 123 (99, 153) | 124 (92, 156) | 129 (103, 163) | 135 (106, 176) | |
| Lagetyp (QRS-Achse, Grad) | Jungen | 97 (75, 140) | 87 (37, 138) | 66 (–6, 107) | 68 (14, 122) | 64 (–4, 118) | 70 (7, 112) | 70 (–10, 112) | 70 (–21, 114) | 65 (–9, 112) |
| Mädchen | 110 (63, 155) | 80 (39, 121) | 70 (17, 108) | 67 (1, 102) | 69 (2, 121) | 69 (3, 106) | 74 (27, 117) | 66 (5, 117) | 66 (5, 101) | |
| QRS-Dauer (ms) | Jungen | 67 (50, 85) | 64 (52, 77) | 66 (54, 85) | 69 (52, 86) | 71 (54, 88) | 75 (58, 92) | 80 (63, 98) | 85 (67, 103) | 91 (78, 111) |
| Mädchen | 67 (54, 79) | 63 (48, 77) | 64 (50, 78) | 64 (52, 80) | 68 (54, 85) | 71 (58, 88) | 77 (59, 95) | 82 (66, 99) | 87 (72, 106) | |
| QTc-Intervall (ms, nach der Bazett-Formel) | Jungen | 413 (378, 448) | 419 (396, 458) | 422 (391, 453) | 411 (379, 449) | 412 (383, 455) | 412 (377, 448) | 411 (371, 443) | 411 (373, 440) | 407 (362, 449) |
Kinder, P-Welle
Rijnbeek et al. Medianwert mit der 98. Perzentile (obere Normgrenze) in Klammern, angegeben in Millivolt (mV). Für Millimeter bei Standardeichung mit 10 multiplizieren.
| Ableitung | 0–1 Mon. | 1–3 Mon. | 3–6 Mon. | 6–12 Mon. | 1–3 J. | 3–5 J. | 5–8 J. | 8–12 J. | 12–16 J. | |
|---|---|---|---|---|---|---|---|---|---|---|
| II | Jungen | 0.15 (0.23) | 0.16 (0.25) | 0.15 (0.22) | 0.16 (0.26) | 0.15 (0.25) | 0.13 (0.23) | 0.12 (0.22) | 0.12 (0.22) | 0.13 (0.24) |
| Mädchen | 0.16 (0.25) | 0.16 (0.23) | 0.16 (0.23) | 0.16 (0.24) | 0.16 (0.25) | 0.13 (0.23) | 0.12 (0.24) | 0.14 (0.24) | 0.15 (0.26) | |
| V1 | Jungen | 0.12 (0.22) | 0.10 (0.19) | 0.09 (0.17) | 0.10 (0.17) | 0.13 (0.20) | 0.12 (0.19) | 0.12 (0.20) | 0.11 (0.19) | 0.11 (0.18) |
| Mädchen | 0.10 (0.19) | 0.10 (0.16) | 0.10 (0.16) | 0.11 (0.21) | 0.12 (0.20) | 0.12 (0.20) | 0.11 (0.18) | 0.11 (0.19) | 0.10 (0.17) |
Kinder, Q-Welle
Rijnbeek et al. Medianwert mit der 98. Perzentile (obere Normgrenze) in Klammern, angegeben in Millivolt (mV).
| Ableitung | 0–1 Mon. | 1–3 Mon. | 3–6 Mon. | 6–12 Mon. | 1–3 J. | 3–5 J. | 5–8 J. | 8–12 J. | 12–16 J. | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| II | Jungen | 0.14 (0.23) | 0.18 (0.32) | 0.14 (0.34) | 0.18 (0.48) | 0.15 (0.44) | 0.11 (0.26) | 0.10 (0.28) | 0.09 (0.24) | 0.08 (0.21) | |
| Mädchen | 0.09 (0.26) | 0.14 (0.32) | 0.15 (0.43) | 0.16 (0.44) | 0.16 (0.48) | 0.13 (0.27) | 0.08 (0.26) | 0.08 (0.21) | 0.09 (0.20) | ||
| III | Jungen | 0.15 (0.26) | 0.29 (0.50) | 0.31 (0.71) | 0.35 (0.79) | 0.30 (0.74) | 0.19 (0.46) | 0.15 (0.36) | 0.10 (0.28) | 0.10 (0.29) | |
| Mädchen | 0.18 (0.35) | 0.24 (0.50) | 0.28 (0.65) | 0.34 (0.79) | 0.31 (0.73) | 0.18 (0.40) | 0.16 (0.38) | 0.10 (0.27) | 0.10 (0.21) | ||
| aVF | Jungen | 0.13 (0.23) | 0.20 (0.35) | 0.20 (0.40) | 0.22 (0.58) | 0.20 (0.54) | 0.14 (0.34) | 0.12 (0.25) | 0.09 (0.25) | 0.08 (0.23) | |
| Mädchen | 0.10 (0.27) | 0.17 (0.35) | 0.20 (0.44) | 0.23 (0.52) | 0.20 (0.54) | 0.12 (0.31) | 0.11 (0.31) | 0.08 (0.21) | 0.09 (0.18) | ||
| V6 | Jungen | 0.11 (0.22) | 0.16 (0.31) | 0.17 (0.35) | 0.20 (0.60) | 0.20 (0.56) | 0.15 (0.42) | 0.12 (0.39) | 0.12 (0.43) | 0.11 (0.43) | |
| Mädchen | 0.09 (0.17) | 0.15 (0.37) | 0.15 (0.40) | 0.18 (0.39) | 0.17 (0.49) | 0.15 (0.42) | 0.10 (0.41) | 0.11 (0.34) | 0.09 (0.23) |
Kinder, R-Welle
Rijnbeek et al. Medianwert mit der 98. Perzentile (obere Normgrenze) in Klammern, angegeben in Millivolt (mV).
| Ableitung | 0–1 Mon. | 1–3 Mon. | 3–6 Mon. | 6–12 Mon. | 1–3 J. | 3–5 J. | 5–8 J. | 8–12 J. | 12–16 J. | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| I | Jungen | 0.25 (0.45) | 0.56 (1.12) | 0.80 (1.52) | 0.82 (1.52) | 0.77 (1.37) | 0.63 (1.09) | 0.62 (1.16) | 0.59 (1.04) | 0.58 (1.09) | |
| Mädchen | 0.31 (0.62) | 0.55 (1.09) | 0.74 (1.26) | 0.75 (1.38) | 0.68 (1.52) | 0.65 (1.20) | 0.49 (1.00) | 0.54 (1.21) | 0.48 (1.02) | ||
| II | Jungen | 0.64 (1.28) | 1.08 (1.76) | 1.27 (1.97) | 1.27 (2.09) | 1.27 (2.47) | 1.36 (2.20) | 1.24 (2.42) | 1.39 (2.23) | 1.31 (2.08) | |
| Mädchen | 0.70 (1.21) | 1.15 (2.04) | 1.33 (2.24) | 1.35 (2.21) | 1.27 (2.34) | 1.38 (2.24) | 1.33 (2.27) | 1.32 (2.29) | 1.32 (2.03) | ||
| III | Jungen | 0.79 (1.44) | 0.76 (1.60) | 0.72 (1.50) | 0.82 (1.65) | 0.80 (1.96) | 0.94 (1.82) | 0.80 (1.92) | 0.89 (1.86) | 0.85 (1.74) | |
| Mädchen | 0.85 (1.50) | 0.91 (1.82) | 0.95 (1.85) | 0.90 (1.95) | 0.96 (2.00) | 0.94 (1.96) | 1.03 (2.09) | 0.92 (1.88) | 0.88 (1.66) | ||
| aVL | Jungen | 0.16 (0.32) | 0.35 (0.66) | 0.40 (1.09) | 0.44 (1.04) | 0.38 (0.86) | 0.26 (0.58) | 0.22 (0.70) | 0.17 (0.52) | 0.19 (0.69) | |
| Mädchen | 0.18 (0.45) | 0.25 (0.69) | 0.37 (0.78) | 0.40 (0.92) | 0.38 (1.02) | 0.24 (0.70) | 0.18 (0.55) | 0.17 (0.69) | 0.16 (0.53) | ||
| aVF | Jungen | 0.59 (1.36) | 0.88 (1.58) | 0.93 (1.70) | 0.96 (1.81) | 1.00 (2.20) | 1.13 (1.97) | 1.00 (2.19) | 1.16 (2.00) | 1.06 (1.88) | |
| Mädchen | 0.72 (1.26) | 0.98 (1.91) | 1.07 (1.82) | 1.11 (2.04) | 1.10 (2.08) | 1.14 (2.06) | 1.20 (2.17) | 1.09 (2.06) | 1.10 (1.84) | ||
| V3R | Jungen | 0.62 (1.04) | 0.58 (1.24) | 0.57 (1.20) | 0.48 (1.24) | 0.49 (1.06) | 0.41 (0.81) | 0.23 (0.63) | 0.22 (0.51) | 0.19 (0.54) | |
| Mädchen | 0.68 (1.26) | 0.55 (0.93) | 0.49 (1.11) | 0.42 (0.98) | 0.43 (0.92) | 0.34 (0.64) | 0.21 (0.57) | 0.19 (0.47) | 0.17 (0.49) | ||
| V1 | Jungen | 1.10 (2.05) | 1.23 (2.07) | 1.32 (2.20) | 1.12 (2.14) | 1.08 (2.11) | 0.95 (1.78) | 0.63 (1.48) | 0.54 (1.14) | 0.48 (1.18) | |
| Mädchen | 1.35 (2.22) | 1.17 (1.99) | 1.14 (2.04) | 1.01 (1.92) | 1.01 (1.91) | 0.77 (1.38) | 0.55 (1.24) | 0.49 (1.14) | 0.35 (1.10) | ||
| V2 | Jungen | 1.83 (2.67) | 1.82 (2.63) | 2.08 (2.54) | 1.94 (2.51) | 1.82 (2.41) | 1.58 (2.26) | 1.21 (2.22) | 1.02 (1.90) | 0.94 (1.87) | |
| Mädchen | 1.83 (2.17) | 1.81 (2.45) | 1.88 (2.60) | 1.82 (2.36) | 1.75 (2.38) | 1.41 (2.25) | 1.06 (1.91) | 0.90 (1.86) | 0.69 (1.57) | ||
| V4 | Jungen | 1.80 (2.62) | 2.30 (3.05) | 2.32 (3.23) | 2.27 (3.32) | 2.37 (3.38) | 2.42 (3.30) | 2.11 (3.11) | 1.86 (3.16) | 1.87 (3.06) | |
| Mädchen | 1.68 (2.21) | 2.26 (3.26) | 2.26 (3.31) | 2.23 (3.09) | 2.21 (3.54) | 2.24 (3.38) | 1.84 (3.04) | 1.72 (3.23) | 1.24 (2.55) | ||
| V6 | Jungen | 1.00 (1.78) | 1.55 (2.23) | 1.65 (2.73) | 1.70 (2.79) | 1.79 (2.96) | 1.94 (3.14) | 1.97 (2.98) | 2.18 (3.24) | 2.02 (3.05) | |
| Mädchen | 0.93 (1.64) | 1.51 (2.67) | 1.60 (2.80) | 1.68 (2.74) | 1.68 (2.67) | 1.89 (2.91) | 2.05 (3.25) | 2.00 (3.04) | 1.65 (2.52) |
Quellen
- Davignon A, Rautaharju P, Boisselle E, et al. Normal ECG standards for infants and children. Pediatr Cardiol. 1979/1980.
- Rijnbeek PR, Witsenburg M, Schrama E, Hess J, Kors JA. New normal limits for the paediatric electrocardiogram. Eur Heart J. 2001;22(8):702-711.
