{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:23:48Z","timestamp":1782271428677,"version":"3.54.5"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    ECG criteria for diagnosing chamber enlargement has poor predictive value. Elevated voltages in mid-precordial leads may have clinical utility and we hypothesized that ECGs with a single mid-precordial voltage\u2009\u2265\u200960\u00a0mV correlate with congenital heart disease (CHD) in a pediatric cohort. This was a retrospective analysis of pediatric ECGs at the University of Minnesota from 2006 to 2021. Included patients had a single mid-precordial lead (V2-V5) QRS voltage\u2009\u2265\u200960\u00a0mV and an echocardiogram within 1\u00a0month. ECG parameters including rhythm, atrial enlargement, axis deviation, hypertrophy criteria and echocardiogram findings were evaluated. Of 122 patients (mean 1.6\u2009\u00b1\u20092.5\u00a0years, 62% male), seventeen (14%) (mean 2.5\u2009\u00b1\u20093.0\u00a0years) had normal anatomy and 105 (86%) (mean 1.5\u2009\u00b1\u20092.4\u00a0years) had CHD. Mean maximum QRS voltage was 75.9\u2009\u00b1\u200913.5\u00a0mV with a significantly higher mean maximum voltage in the CHD versus control group (77.0\u2009\u00b1\u200913.7 vs 69.2\u2009\u00b1\u20099.7\u00a0mV,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.012). A receiver operating characteristic curve for maximum QRS voltage had an AUC of 0.691 (95% CI 0.546\u20140.835). 66.5\u00a0mV had the best sensitivity (76%) and specificity (59%) combination and a value of 92.5\u00a0mV had a specificity of 100% for CHD. A QRS voltage of 60\u00a0mV in mid-precordial leads was associated with CHD in a cohort of pediatric patients. Echocardiograms remain reasonable in these patients though larger cohort studies are needed to develop ideal cutoffs.\n                  <\/jats:p>","DOI":"10.1007\/s00246-025-03890-w","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T12:37:40Z","timestamp":1748003860000},"page":"1178-1182","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic Utility of Prominent Mid-Precordial Lead Voltage in a Pediatric Population"],"prefix":"10.1007","volume":"47","author":[{"given":"Michael","family":"White","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gormley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"3890_CR1","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/S0002-8703(37)91211-0","volume":"13","author":"LN Katz","year":"1937","unstructured":"Katz LN, Wachtel H (1937) The diphasic QRS type of electrocardiogram in congenital heart disease. Am Heart J 13:202\u2013206","journal-title":"Am Heart J"},{"key":"3890_CR2","unstructured":"Allen HD. (2016). Moss & Adams\u2019 Heart disease in infants, children, and adolescents, including the fetus and young adult. Available from: Wolters Kluwer, (9th Edition). Wolters Kluwer Health"},{"issue":"3","key":"3890_CR3","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1542\/peds.2005-2985","volume":"118","author":"MD Puchalski","year":"2006","unstructured":"Puchalski MD, Lozier JS, Bradley DJ, LuAnn Minich L, Tani LY (2006) Electrocardiography in the diagnosis of right ventricular hypertrophy in children. Pediatrics 118(3):1052\u20131055. https:\/\/doi.org\/10.1542\/peds.2005-2985","journal-title":"Pediatrics"},{"issue":"4","key":"3890_CR4","doi-asserted-by":"publisher","first-page":"E164","DOI":"10.1111\/chd.12249","volume":"10","author":"A Bratincs\u00e1k","year":"2015","unstructured":"Bratincs\u00e1k A, Williams M, Kimata C, Perry JC (2015) The electrocardiogram is a poor diagnostic tool to detect left ventricular hypertrophy in children: a comparison with echocardiographic assessment of left ventricular mass. Congenit Heart Dis 10(4):E164-71. https:\/\/doi.org\/10.1111\/chd.12249. (Epub 2015 Jan 20 PMID: 25600360)","journal-title":"Congenit Heart Dis"},{"issue":"5","key":"3890_CR5","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1007\/s00246-008-9235-y","volume":"529","author":"PR Rijnbeek","year":"2008","unstructured":"Rijnbeek PR, van Herpen G, Kapusta L, Ten Harkel AD, Witsenburg M, Kors JA (2008) Electrocardiographic criteria for left ventricular hypertrophy in children. Pediatr Cardiol 529(5):923\u20138. https:\/\/doi.org\/10.1007\/s00246-008-9235-y. (Epub 2008 Apr 25 PMID: 18437446 PMCID: PMC2525851)","journal-title":"Pediatr Cardiol"},{"issue":"5","key":"3890_CR6","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s00246-024-03448-2","volume":"45","author":"ME Alexander","year":"2024","unstructured":"Alexander ME, Gongwer R, Trachtenberg FL, Minich LL, Triedman JK, Kaltman JR, Czosek RJ, Tristani-Firouzi M, LaPage MN, Tsao SS, Radbill AE, Dilorenzo MP, Kovach JR, Stephenson EA, Janson C, Mao C, Salerno JC, Clark BC, Mahgerefteh J, Pilcher T, Johnson TR, Kim JJ, Valdes SO, Cain N, Jackson L, Saarel EV (2024) Limited relationship between echocardiographic measures and electrocardiographic markers of left ventricular size in healthy children. Pediatr Cardiol 45(5):1055\u20131063","journal-title":"Pediatr Cardiol"},{"key":"3890_CR7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1970","author":"AE Schneider","year":"2018","unstructured":"Schneider AE, Cannon BC, Johnson JN, Ackerman MJ, Wackel PL (2018) Left axis deviation in children without previously known heart disease. Pediatrics. https:\/\/doi.org\/10.1542\/peds.2017-1970","journal-title":"Pediatrics"},{"issue":"2","key":"3890_CR8","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1111\/chd.12294","volume":"11","author":"P Ravi","year":"2016","unstructured":"Ravi P, Ashwatth R, Strainic J, Li H, Steinberg J, Snyder C (2016) Clinical and financial impact of ordering an echocardiogram in children with left axis deviation on their electrocardiogram. 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