Abstract: Background：Cardiovascular complications have become the leading cause of death in children with Duchenne muscular dystrophy(DMD). Electrocardiography(ECG) is emerging as an early sensitive indicator for monitoring myocardial involvement in this population. Objective：To analyze ECG characteristics in children with DMD. Design：Retrospective cohort study. Methods：The characteristics of 486 ECG in 304 children with genetically diagnosed DMD were retrospectively analyzed, and compared with 112 ECG indices of 112 normal children in each age group. Main outcome measures：The incidence and type of ECG abnormalities in children with DMD. Results：The overall incidence of abnormal ECG in children with DMD was 38.7% (188/486). ECG abnormalities mainly include sinus tachycardia, left ventricular hyper voltage/left ventricular hypertrophy, right ventricular hypertrophy, double ventricular hypertrophy, STT changes, T wave changes, pathological Q waves,incomplete right bundle branch block(ICRBBB), complete right bundle branch block(CRBBB), ventricular block, atrial premature beats/ventricular premature beats and short PR syndrome.No long QT syndrome and other types of conduction block were identified. The incidence of abnormal ECG in children with DMD regardless of LVEF increased significantly with age (P<0.05), and children with DMD had significantly faster heart rate, significantly shortened PR interval, and significantly increased amplitude of RV1 and RV5, compared to agematched healthy children (P<0.05). Conclusions：ECG abnormalities are common manifestations in children with DMD, and their incidence gradually increases with age, and increased heart rate, shortened PR interval, and increased RV1 amplitude are early characteristic changes in ECG abnormalities in children with DMD.

Key words: Keywords Muscular dystrophy, Duchenne, Electrocardiography, Pediatrics