ECG interpretation: what is different in children?

While the electrical waveforms and basic approach to electrocardiogram (ECG) interpretation are similar for pediatric and adult patients, some important differences must be recognized to provide appropriate care for infants and children. Maturational changes that occur over the early childhood years result in differences in normal heart rates, interval durations, and ventricular dominance. Any arrhythmia seen in adults can occur in the pediatric patient; however, the most common variations from normal rhythms are sinus arrhythmia, bradycardia, and supraventricular tachycardia. Nurses caring for infants and children must recognize the important similarities and differences in rhythm strip interpretation between the adult and the pediatric patient.