European Heart Journal (2002) 23, 1329–1344 doi:10.1053/euhj.2002.3274, available online at http://www.idealibrary.com on Task Force Report Guidelines for the interpretation of the neonatal electrocardiogram A Task Force of the European Society of Cardiology P. J. Schwartz 1 (Chair), A. Garson, Jr 2 , T. Paul 3 , M. Stramba-Badiale 4 , V. L. Vetter 5 , E. Villain 6 and C. Wren 7 1 Department of Cardiology, University of Pavia and IRCCS Policlinico S. Matteo, Pavia, Italy; 2 University of Virginia, Charlottesville, VA, U.S.A.; 3 The Children’s Heart Program of South Carolina, Medical University of South Carolina, Charleston, SC, U.S.A.; 4 Pediatric Arrhythmias Center, IRCCS Istituto Auxologico Italiano, Milan, Italy; 5 Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, U.S.A.; 6 Division of Pediatric Cardiology, Department of Pediatrics, Ho ˆpital Necker Enfants Malades, Paris, France; 7 Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, U.K. Introduction.............................................................1329 Normal electrocardiogram in the newborn .............1330 Normal values......................................................1330 Technology ..........................................................1330 Artefacts...............................................................1332 Electrocardiographic measurements ....................1332 Heart rate.............................................................1332 P wave..................................................................1332 QRS complex .......................................................1332 QT interval ..........................................................1333 ST segment and T wave ......................................1333 Abnormal electrocardiogram in the newborn .........1333 Heart rate.............................................................1333 Sinus arrhythmia ..............................................1333 Sinus tachycardia .............................................1333 Sinus bradycardia.............................................1335 Other bradycardias...........................................1335 P wave..................................................................1335 Atrioventricular conduction.................................1335 Complete (3rd) atrioventricular block .............1335 1st and 2nd atrioventricular block ...................1336 Intraventricular conduction .................................1336 Bundle branch block ........................................1336 Non-specific intraventricular conduction abnormalities ....................................................1336 Wolff–Parkinson–White syndrome ..................1336 QRS axis and amplitude ......................................1338 Right ventricular hypertrophy .........................1338 Left ventricular hypertrophy ............................1338 Low QRS voltage.............................................1338 Ventricular repolarization ....................................1338 QT prolongation: differential diagnosis ...........1339 Long QT syndrome ..........................................1339 ST segment elevation .......................................1341 Atrial and ventricular arrhythmias ......................1341 Atrial/junctional ...............................................1341 Premature atrial beats ..................................1341 Supraventricular tachycardia........................1342 Atrial flutter .................................................1342 Ventricular arrhythmias ...................................1342 Premature ventricular beats..........................1342 Ventricular tachycardia ................................1343 Accelerated ventricular rhythm ....................1343 Conclusion ...............................................................1343 Acknowledgements ..................................................1343 References ................................................................1343 Introduction Most cardiologists who care for adults have no or minimal experience with electrocardiograms (ECGs) recorded in infants. So far, this has had no practical implications because only seldom are they requested to examine a neonatal ECG. This situation, however, may change as some European countries have begun to consider the possibility of introduc- ing in their National Health Services the performance of an ECG during the first month of life in all newborns, as part of a cardiovascular screening programme. Correspondence: Peter J. Schwartz, MD, FESC, FACC,, FAHA, Professor & Chairman, Department of Cardiology, Policlinico S. Matteo IRCCS, Viale Golgi, 19-27100 Pavia, Italy. 0195-668X/02/$35.00  2002 Published by Elsevier Science Ltd on behalf of The European Society of Cardiology