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How to interpret the paediatric 12-lead ECG
  1. Paraskevi Mikrou1,
  2. Pushpa Shivaram2,
  3. Constantinos Kanaris3,4
  1. 1 Paediatric Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
  2. 2 Division of Pediatric Cardiology, Augusta University Medical College of Georgia, Augusta, Georgia, USA
  3. 3 Paediatric Intensive Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  4. 4 Blizard Institute, Queen Mary University of London, London, UK
  1. Correspondence to Dr Constantinos Kanaris, Paediatric Intensive Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; ckanaris{at}


ECG interpretation is a core skill for any healthcare practitioner that looks after children. The article aims to educate the reader in basic interpretation of paediatric ECG in a succinct, interactive, organised manner in a way that it can be easily referenced and applied in everyday clinical practice. We include clinical examples as well as age and sex-related reference ranges for QT intervals, P-wave duration, Q-wave amplitude, QRS complex duration, R-wave and S-wave amplitude, R/S ratio and PR intervals.

  • cardiology
  • physiology
  • intensive care units
  • paediatric
  • paediatric emergency medicine
  • paediatrics

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  • Twitter @voulamik, @PushpaShivaram, @DrKanaris

  • Contributors The authors contributed equally to the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Author note The cases are based on fictitious patients and have been created to help the reader think and apply the clinical approach portrayed in the paper as if they were real scenarios.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.