Sinoatrial conduction in children: an index of sinoatrial node function.

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Abstract
The premature atrial stimulus technique was used to evaluate sinotrial conduction (SAC) in 50 children (age range 6 mo. to 21 yr; median 6.5 yr) to obtain normal values of sinoatrial conduction time (SACT) and to determine the usefulness of the technique in evaluation of sinoatrial node (SAN) dysfunction in children. The results in the normal group (n = 20) were compared with those of patients with documented SAN dysfunction (group 1, n = 20) or at risk to develop SAN dysfunction because of a previous intracardiac operation (group 2, n = 10). Of 30 patients in groups 1 and 2, 23 had undergone an intracardiac operation, 13 Mustard operations and 5 closures of an atrial septal defect. In group 1, the mean value of total SACT was 172 ms .+-. 42 (SD) compared with 124 ms .+-. 38 in the normal group (P < 0.001). All 20 patients in group 1 had abnormal SAN automaticity (prolonged corrected sinus node recovery time, CSNRT) and 13 of 20 had abnormal SAC. While all 10 patients in group 2 had normal CSNRT, 2 had abnormal SAC. The evaluation of SAC should be included in the assessment of children with suspected SAN dysfunction.