Attention deficit hyperactivity disorder screening electrocardiograms: A community-based perspective

Shilpa A. Shahani, William N. Evans, Gary A. Mayman, Vincent C. Thomas

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)485-489
Number of pages5
JournalPediatric Cardiology
Volume35
Issue number3
DOIs
StatePublished - Mar 2014

Fingerprint

Attention Deficit Disorder with Hyperactivity
Electrocardiography
Referral and Consultation
Cardiac Arrhythmias
Heart Rate
Left Ventricular Hypertrophy
Cardiology
Exercise Test
Heart Diseases
Population

Keywords

  • ADHD
  • EKG
  • Screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Attention deficit hyperactivity disorder screening electrocardiograms : A community-based perspective. / Shahani, Shilpa A.; Evans, William N.; Mayman, Gary A.; Thomas, Vincent C.

In: Pediatric Cardiology, Vol. 35, No. 3, 03.2014, p. 485-489.

Research output: Contribution to journalArticle

Shahani, Shilpa A. ; Evans, William N. ; Mayman, Gary A. ; Thomas, Vincent C. / Attention deficit hyperactivity disorder screening electrocardiograms : A community-based perspective. In: Pediatric Cardiology. 2014 ; Vol. 35, No. 3. pp. 485-489.
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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.",
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