Key result
Neonates with atrial septal defects had significantly longer P-wave durations (58 vs. 56 ms) and PR intervals (100 vs. 96 ms) compared to matched controls as early as the first week after birth.
Why the study?
Arrhythmias and ECG abnormalities are common in patients with ASDs, but whether these abnormalities are present in the neonatal stage or develop later secondary to hemodynamic changes was unknown.
Case-Control (n=1,752)
Yes
Neonates with atrial septal defects exhibit altered cardiac electrical activity, including longer P-wave durations and PR intervals, as early as the first week of life compared to healthy controls.
Answers are grounded in this paper and cite their sources.
Early ECG changes in ASD neonates merit longitudinal study; leaves open prognostic value for arrhythmias or management implications.
Arrhythmias and electrocardiographic (ECG) abnormalities are common among patients with atrial septal defects (ASDs). We studied a large cohort of neonates with ASDs to investigate whether ECG abnormalities are present at this early stage or develop later, secondary to hemodynamic changes. We analyzed the echocardiograms and ECGs from the Copenhagen Baby Heart Study, a population-based cohort study. We compared ECG characteristics of 438 neonates with secundum ASDs to 1314 matched controls. In subgroup analyses, we investigated whether electrocardiographic characteristics were associated with age at examination. Neonates with ASDs (median age, 11 days; males, 51%) had longer P-wave durations (58 vs. 56 ms, p < 0.001), PR intervals (100 vs. 96 ms, p < 0.001), and a more rightward-shifted QRS axis (116 vs. 114 degrees, p = 0.032) compared to controls (median age, 10 days; males, 51%). There were no differences between cases and controls in the P-wave area, amplitude, or axis. Subgroup analyses showed that the differences in P-wave duration and PR interval were present in neonates examined in the first week after birth. The difference in the QRS axis was not found in neonates examined this early but was found in neonates examined at age two to four weeks. In conclusion, ASDs are associated with ECG changes from the neonatal phase. The P-wave duration and PR interval are longer in neonates with ASDs when compared to controls as early as the first week after birth, indicating that these changes are not purely secondary, but that neonates with an ASD have altered cardiac electrical activity.ClinicalTrials.gov Identifier NCT02753348 (April 27, 2016).
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Dehn et al. (2023) conducted a case-control in Atrial Septal Defect (n=1,752). Atrial Septal Defect (ASD) vs. Matched controls without ASD was evaluated on P-wave duration (ms) (p=<0.001). Neonates with atrial septal defects had significantly longer P-wave durations (58 vs. 56 ms) and PR intervals (100 vs. 96 ms) compared to matched controls as early as the first week after birth.
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