Early Identification of Prolonged QT Interval for Prevention of Sudden Infant Death
Por:
Sarquella-Brugada G, Algarrada L, Zambrano MD, Fernández-Falgueres A, Sailer S, César-Díaz S, Sebastiani G, Martí-Almor J, Aurensanz E, Cruzalegui JC, Merchan EF, Coll M, Pérez-Serra A, Del Olmo B, Fiol JV, Iglesias A, Ferrer-Costa C, Puigmulé M, Lopez L, Pico F, Arbelo E, Jordà P, Brugada-Terradellas J, Brugada R and Campuzano O
Publicada:
29 jul 2021
Ahead of Print:
29 jul 2021
Categoría:
Pediatrics, perinatology and child health
Resumen:
Introduction: Long QT syndrome is the main arrhythmogenic disease responsible for sudden death in infants, especially in the first days of life. Performing an electrocardiogram in newborns could enable early diagnosis and adoption of therapeutic measures focused on preventing lethal arrhythmogenic events. However, the inclusion of an electrocardiogram in neonatal screening protocols still remains a matter of discussion. To comprehensively analyse the potential clinical value of performing an electrocardiogram and subsequent follow-up in a cohort of newborns.
Methods: Electrocardiograms were performed in 685 neonates within the first week of life. One year follow-up was performed if QTc > 450 ms identified. Comprehensive genetic analysis using massive sequencing was performed in all cases with QTc > 470 ms.
Results: We identified 54 neonates with QTc > 450 ms/ 480 ms at birth and, if persistent, pharmacological treatment was administrated during follow-up. A rare variant was identified as the potential cause of long QT syndrome in five cases. Three cases showed a family history of sudden arrhythmogenic death.
Conclusions: Our prospective study identifies 0.14% of cases with a definite long QT, supporting implementation of electrocardiograms in routine pediatric protocols. It is an effective, simple and non-invasive approach that can help prevent sudden death in neonates and their relatives. Genetic analyses help to unravel the cause of arrhythmogenic disease in diagnosing neonates. Further, clinical assessment and genetic analysis of relatives allowed early identification of family members at risk of arrhythmias helping to adopt preventive personalized measures.
Filiaciones:
Sarquella-Brugada G:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Medical Science Department, School of Medicine, University of Girona, Girona, Spain
Algarrada L:
Department of Neonatology, Hospital Clínic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatología, BCNatal, Barcelona, Spain
Zambrano MD:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Fernández-Falgueres A:
Cardiology Service, Hospital Josep Trueta, University of Girona, Girona, Spain
Sailer S:
Department of Neonatology, Hospital Clínic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatología, BCNatal, Barcelona, Spain
Department of Neonatology, Faculty of Medicine, Kepler University Hospital, Johannes Kepler University, Linz, Austria
César-Díaz S:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Sebastiani G:
Department of Neonatology, Hospital Clínic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatología, BCNatal, Barcelona, Spain
Martí-Almor J:
Department of Cardiology, Hospital del Mar, Barcelona, Spain
Aurensanz E:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Cruzalegui JC:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Merchan EF:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Coll M:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Pérez-Serra A:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Del Olmo B:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Fiol JV:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Iglesias A:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Ferrer-Costa C:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Puigmulé M:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Lopez L:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Pico F:
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Arbelo E:
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Arrhythmias Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
Jordà P:
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Arrhythmias Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
Brugada-Terradellas J:
Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Arrhythmias Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
Brugada R:
Medical Science Department, School of Medicine, University of Girona, Girona, Spain
Cardiology Service, Hospital Josep Trueta, University of Girona, Girona, Spain
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Campuzano O:
Medical Science Department, School of Medicine, University of Girona, Girona, Spain
Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
Green Published, Green Submitted, gold
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