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Electrocardiographic Screening in the First Days of Life for Diagnosing Long QT Syndrome: Findings from a Birth Cohort Study in Germany

Authors
  • Simma, Alexander
  • Potapow, Antonia
  • Brandstetter, Susanne
  • Michel, Holger
  • Melter, Michael
  • Seelbach-Göbel, Birgit
  • Apfelbacher, Christian
  • Kabesch, Michael
  • Gerling, Stephan
Type
Published Article
Journal
Neonatology
Publisher
S. Karger AG
Publication Date
Nov 12, 2020
Volume
117
Issue
6
Pages
756–763
Identifiers
DOI: 10.1159/000511572
PMID: 33181513
Source
Karger
Keywords
License
Green
External links

Abstract

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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