Complex electrocardiographic findings in a neonate with long QT syndrome

A case of long QT syndrome diagnosed in the early neonatal period is described. A full-term male baby was delivered by cesarean section at 38 weeks of gestation. The indication to cesarean section was sudden marked fetal bradycardia. At birth, he presented the following rhythm disorders: a) an ectopic atrial rhythm with T wave alternans, and b) atrioventricular conduction disorders. Sinus rhythm, with a prolonged QT interval and T wave alternans, was recovered soon after birth, before starting beta-blocker therapy. The family history was negative for the long QT syndrome: sudden unexpected death and/or syncopal episodes and cases of congenital deafness have not been reported. Molecular screening of the five long QT syndrome-related genes did not reveal the presence of any mutation. At 3 years of follow-up, the child is well and he did not present with symptoms or arrhythmias during this period.