OBJECTIVETo investigate the characteristics of 24-hr ambulatory electrocardiography (DCG) of children with myocarditis and to study the clinical value of DCG in the diagnosis of childhood myocarditis.

METHODS24-hr DCG findings, including abnormal DCG rate, and number, grade and distribution of ventricular premature beat (PVC), as well as heart rate variability, from 59 children with myocarditis were retrospectively reviewed and compared with those detected in 41 children without heart disease.

RESULTS86.4% of patients with myocarditis showed abnormal DCG, and compound arrhythmia was commonly seen, but only 46.3% showed abnormal DCG (P < 0.01) and single arrhythmia was predominant in the control group. The number and grade of PVC/24 hrs were not significantly different between the two groups. Compared with the control group, the average pattern PVC was predominant in the myocarditis group (84.6% vs 48.7%; P < 0.05). Monopeak pattern PVC was mostly seen (64.4%), followed by multiple-peak pattern (25.4%) and bi-peak pattern (8.4%) in the myocarditis group, which were significantly different from the control group: monopeak pattern 53.6%, bi-peak pattern 36.6% and multiple-peak pattern 7.3% (P < 0.01).

CONCLUSIONSThe 24-hr DCG characteristics of children with myocarditis are different from the normal controls, suggesting 24-hr DCG monitoring is useful to the diagnosis of childhood myocaditis.