Abstract: Objective To investigate the relationship between chest wall deformity with congenital pectus excavatum (PE) and abnormal electrocardiogram (ECG) in children. Methods Sixty-five children who met the PE standard were selected as the case group, and 65 healthy children matched in gender and age in the same period were selected as the control group. Sixty-five PE children were divided into subgroups according to whether they had left atrial abnormality or right axis deviation or incomplete right bundle branch block (IRBBB). The general data, Haller index and the differences of cardiac rotation angle were compared between different groups. The amplitude of negative P wave in lead V1 was measured in children with PE. Spearman correlation analysis was performed to estimate the correlation between the amplitude of negative P wave in lead V1 and Haller index, and the correlation between the amplitude of negative P wave in lead V1 and cardiac rotation angle. Results The proportion of left atrial abnormality, IRBBB and right axis deviation was significantly higher in the PE group than that in the control group (P＜0.05). The amplitude of negative P wave in V1 lead was larger in the PE group than that in the control group (P＜0.01). The cardiac rotation angle and Haller index were higher in the left atrial abnormality group than those in the non-left atrial abnormality group (P＜0.01). The cardiac rotation angle and Haller index were higher in the IRBBB group than those in the non-IRBBB group (P＜0.01). However, there were no significant differences in cardiac rotation angle and Haller index between the right axis deviation group and the non-axis right deviation group. In addition, the amplitude of negative P wave in lead V1 was positively correlated with Haller index and cardiac rotation angle in children with PE (rs=0.573 and 0.658 respectively, P＜0.01). Conclusion Left atrial abnormality, IRBBB and right axis deviation are common in children with PE. The abnormal ECG has the practical value in the evaluation of chest wall deformity in PE.

Key words: funnel chest, electrocardiography, thoracica, child, Haller index