Single-centre retrospective analysis of the best timing for the QTc interval length assessment in neonates.

Abstract

Objective:

To evaluate the best timing for ECG screening in order to diagnose long QT syndrome and lower, at the same time, the false positives.

Design:

We retrospectively evaluated the corrected QT (QTc) interval in the clinical reports of the ECG screening performed, as per internal protocol.

Setting:

An outpatient setting in our Unit of Neonatology and Pediatrics, Santa Maria Goretti Hospital in Latina, Italy.

Patients:

We enrolled 3467 healthy neonates between 14 and 30 days of life.

Interventions:

The newborns with abnormal QTc interval were invited to subsequent revaluation every 21 days, until normalisation or necessity to refer to a tertiary paediatric cardiology centre.

Main outcome measures:

Difference in QTc according to patients' characteristics and number of false positives at second ECG evaluation.

Results:

At first evaluation, 249 (7.2%) newborns had prolonged QTc. We did not find any significant difference in the QTc length according to gestational age (p=0.40) and birth weight (p=0.81). As expected, girls had longer QTc than boys (p=0.01). Only 11 out of 240 (4.6%) and 1 out of 238 infants (0.4%) had persistently prolonged QTc at second and third ECG evaluation, respectively. The QTc decreased significantly at second (p<0.0001) and third evaluation (p=0.0035).

Conclusions:

In our study, we showed that a single screening performed in healthy infants after 60 days of life could reduce the risk of false positives, with a beneficial impact on public national health system and the chance to start early therapy in case of long QT syndrome.

• Authors: Alessia Marcellino, Jessica Luchetti, Massimo Raponi, Raffaele Falsaperla, Carmelo Pirone, Maria Katia Fares, Flavia Ventriglia, Riccardo Lubrano
• Journal: BMJ paediatrics open (BMJ Paediatr Open) Vol. 5 Issue 1 Pg. e001026 ( 2021) ISSN: 2399-9772 [Electronic] England
• PMID: 34079915 (Publication Type: Journal Article)
• Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Child
• Electrocardiography
• Female
• Humans
• Infant
• Infant, Newborn
• Italy (epidemiology)
• Long QT Syndrome (diagnosis)
• Male
• Retrospective Studies