Key result
Newborn ECG screening identifies QTc prolongation in ~0.6% of neonates, leading to congenital LQTS diagnoses.
Why the study?
Newborn sudden infant death syndrome has not decreased in recent decades and LQTS contributes to almost 10% of cases, making early identification through neonatal ECG screening a potential strategy to reduce mortality.
Does electrocardiogram (ECG) screening in the first days of life improve the diagnosis of congenital LQTS in newborns?
Cohort (n=2,251)
Does electrocardiogram (ECG) screening in the first days of life improve the diagnosis of congenital LQTS in newborns?
Standardized neonatal ECG screening in the first days of life can identify neonates with prolonged QT intervals and aid in diagnosing congenital LQTS.
Neonatal ECG screening may aid congenital LQTS detection; hypothesis-generating and requires prospective validation before practice change.
INTRODUCTION: Newborn sudden infant death syndrome (SIDS) has failed to decrease in the last decades, and a third of the neonatal cases occurred within the first 6 days of life. The long QT syndrome (LQTS) is a genetic disease with a prevalence of 1 in 2,000 live births and contributes to almost 10% of SIDS cases. Early identification of LQTS through electrocardiogram (ECG) screening is likely to reduce mortality. METHODS AND RESULTS: In this ongoing prospective study we evaluated 2,251 ECGs from newborns participating in the KUNO Kids birth cohort study between July 2015 and July 2018. ECGs were recorded at a mean age of 2.0 days (IQR 0 days). The QT interval was corrected for heart rate using Bazett's formula (QTc). A QTc between 451 and 460, 461-470, and >470 ms was measured in 23 (1.0), 14 (0.6), and 62 (2.8%) participants, respectively. Fourteen neonates (0.62%) were admitted and monitored because their initial QTc was ≥500 ms. In 2 genetically analyzed participants, a mutation was found. One disease-causing for LQTS type 1 and the other of unclear significance. Cascade screening revealed affected members in both families. CONCLUSION: A standardized neonatal ECG screening in the first days of life is able to identify neonates with a relevant transient form of prolonged QT intervals and to aid diagnosing congenital LQTS.
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Simma et al. (2020) conducted a cohort in Long QT Syndrome (n=2,251). Electrocardiographic (ECG) screening was evaluated on QTc interval prolongation and diagnosis of congenital LQTS. Electrocardiographic screening in 2,251 newborns identified 14 neonates (0.62%) with QTc ≥500 ms, leading to the diagnosis of congenital LQTS in 2 participants.
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