Pediatr Cardiol
DOI
10.1007/s00246-013-0810-5
_ Springer Science+Business Media New York 2013
Received: 19 July 2013 /
Accepted: 24 September 2013
Attention Deficit Hyperactivity Disorder Screening Electrocardiograms:
A Community-Based Perspective
Authors
Shilpa A Shahani, MD, William N Evans, MD, Gary A Mayman, MD,
Vincent C Thomas, MD
Source
ChildrenŐs Heart Center
Nevada, 3006 S Maryland Pkwy, Ste 690, Las Vegas, Nevada 89109, USA. Email: vthomas@childrensheartcenter.com.
Abstract
Screening electrocardiograms
(EKGs) for attention deficit hyperactivity disorder (ADHD) medication administration
is controversial. We reviewed our experience as a community-based cardiology
group. We reviewed all ADHD screening EKGs during a 2-year period.
We evaluated whether
screening EKGs resulted in further consultation and if management was altered.
We also evaluated differences between patients on ADHD medications and those
starting ADHD medications and further stratified the patients into stimulant
versus nonstimulant groups. A total of 691 screening
EKGs met our criteria. Forty-two patients (6.1 %) were recommended for further
consultation. EKG findings requiring consultation included the following: left-ventricular
hypertrophy, right atrial enlargement, arrhythmia, prolonged QT, and axis deviation.
Studies performed during consultation included 39 echocardiograms, 2 stress
tests, 2 Holter monitors, and 1 heart card. Five
patients (0.72 %) were identified to have
cardiac disease,
one of whom decided against starting ADHD medications due to an arrhythmia,
resulting in a change in management (0.14 %). Results comparing mean age, heart
rate, and corrected QT interval between patients on medication and patients
starting medications were as follows: 10.06 years, 82.87, bpm and 405.24 ms
compared with 9.99 years, 80.05 bpm, and 405.82 ms, respectively (p = not significant [NS], p = 0.013 [NS], respectively). Results
comparing mean age, heart rate, and corrected QT interval between patients on
stimulant versus nonstimulant medications were as
follows: 9.68 years, 83.10 bpm, and 403.04 ms compared with 9.81 years, 80.10
bpm, and 407.08 ms, respectively (p =
NS for all). In our population, screening EKGs rarely resulted in
management changes for patients taking or starting ADHD medications.