Related Experiment Video
Updated: Nov 3, 2025
Noninvasive Electrocardiography in the Perinatal Mouse
Published on: June 12, 2020
Single-centre retrospective analysis of the best timing for the QTc interval length assessment in neonates
Alessia Marcellino1, Jessica Luchetti1, Massimo Raponi2
1Pediatrics and Neonatology Unit, Maternal-Child Department, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy.
Insights
Screening healthy infants for long QT syndrome after 60 days of life can reduce false positives. This optimized ECG screening timing aids early diagnosis and treatment, benefiting public health.
Area of Science:
- Pediatric Cardiology
- Clinical Electrophysiology
- Neonatal Screening
Background:
- Long QT syndrome (LQTS) is a critical condition requiring timely diagnosis.
- Current ECG screening protocols may lead to a high rate of false positives in neonates.
- Optimizing screening timing is crucial for accurate LQTS diagnosis and resource management.
Purpose of the Study:
- To determine the optimal timing for ECG screening in neonates to diagnose LQTS.
- To minimize false positive results in ECG screening for LQTS.
Main Methods:
- Retrospective analysis of corrected QT (QTc) intervals from ECG screenings in 3467 healthy neonates (14-30 days old).
- Follow-up ECG evaluations every 21 days for infants with abnormal QTc.
- Analysis of QTc interval differences based on patient characteristics and false positive rates.
Main Results:
- Initial ECG screening revealed prolonged QTc in 7.2% of neonates.
- No significant QTc difference was found based on gestational age or birth weight.
- Girls exhibited longer QTc intervals than boys (p=0.01).
- Persistent QTc prolongation was low (4.6% at second, 0.4% at third evaluation), with significant QTc decrease over time.
Conclusions:
- A single ECG screening after 60 days of life in healthy infants can reduce false positives.
- This optimized screening strategy can improve healthcare system efficiency.
- Early identification and treatment of LQTS are facilitated by improved screening protocols.
Objective:
To evaluate the best timing for ECG screening in order to diagnose long QT syndrome and lower, at the same time, the false positives.
Design:
We retrospectively evaluated the corrected QT (QTc) interval in the clinical reports of the ECG screening performed, as per internal protocol.
Setting:
An outpatient setting in our Unit of Neonatology and Pediatrics, Santa Maria Goretti Hospital in Latina, Italy.
Patients:
We enrolled 3467 healthy neonates between 14 and 30 days of life.
Interventions:
The newborns with abnormal QTc interval were invited to subsequent revaluation every 21 days, until normalisation or necessity to refer to a tertiary paediatric cardiology centre.
Main Outcome Measures:
Difference in QTc according to patients' characteristics and number of false positives at second ECG evaluation.
Results:
At first evaluation, 249 (7.2%) newborns had prolonged QTc. We did not find any significant difference in the QTc length according to gestational age (p=0.40) and birth weight (p=0.81). As expected, girls had longer QTc than boys (p=0.01). Only 11 out of 240 (4.6%) and 1 out of 238 infants (0.4%) had persistently prolonged QTc at second and third ECG evaluation, respectively. The QTc decreased significantly at second (p<0.0001) and third evaluation (p=0.0035).
Conclusions:
In our study, we showed that a single screening performed in healthy infants after 60 days of life could reduce the risk of false positives, with a beneficial impact on public national health system and the chance to start early therapy in case of long QT syndrome.
Related Concept Videos
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:24ECG Interpretation of Rhythms
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....