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अमूर्त

Newborn Electrocardiography as a Screening Method for Long-QT Syndrome

Torres F, Hernández M, Garcia J, Marti-Almor J and Garcia-Algar O

Prolongation of the QT interval is the cause of about 10% cases of sudden infant death syndrome (SIDS) in newborns but it is also responsible for about 5% of sudden deaths in adults. LQTS is associated with life threatening arrhythmias such us torsade de pointes ventricular tachycardia or ventricular fibrillation (VF) leading to sudden death. Congenital causes (channelopathies) of LQTS are associated to mutations with different hereditary pattern according affected gene but it has been proven that several drugs and electrolytic alterations can significantly increase the QT interval. However, the cost-effectiveness of neonatal electrocardiographic (EKG) screening has been questioned and despite studies made in newborns there is still no consensus about the best moment to make and electrocardiographic screening. Previous studies demonstrate that newborns with QTc values over 470 msec often normalize by themselves in the first month of life. However in some cases these values remain high after first months of life. These cases are more frequently in determinate ethnics (Maghreb, Morocco and India-Pakistan). These races could be linked to cardiac electrical alterations with a hereditary pattern of variable penetrance. An EKG performed in the first month of life will allow the early identification of still asymptomatic infants with LQTS and also infants with some correctable congenital heart defects (CHD) not recognized by routine neonatal examinations. Appropriate therapy will prevent unnecessary deaths in infants, children, and young adults. At the light of this literature review we could assess that neonatal electrocardiographic screening is highly cost-effective and it may permit the early identification of infants at risk for SIDS.