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Consequences of electrocardiography screening for prolonged QTc in neonates-A systematic review

Anna Leppänen1, Emmi Helle2, Ilari Kuitunen3

  • 1Kuopio Pediatric Research Unit, University of Eastern Finland, Kuopio, Finland.

Heart Rhythm
|March 6, 2025
PubMed

Insights

Neonatal electrocardiography (ECG) screening for prolonged corrected QT (QTc) interval shows wide incidence rates. Few infants with prolonged QTc are diagnosed with long QT syndrome (LQTS), indicating a need for further research.

Area of Science:

  • Neonatal cardiology
  • Clinical electrophysiology
  • Genetics

Background:

  • Effectiveness of neonatal electrocardiography (ECG) screening for long QT syndrome (LQTS) remains under discussion.
  • Current screening practices may lead to varied interpretations and outcomes.

Purpose of the Study:

  • To systematically review the consequences of ECG screening for prolonged corrected QT (QTc) interval in neonates.
  • To analyze incidence rates, QTc normalization, LQTS diagnoses, and sudden infant death syndrome (SIDS) in screened infants.

Main Methods:

  • Systematic literature search of PubMed, Scopus, and Web of Science databases (June 2024).
  • Calculation of incidence rates for prolonged QTc (>450 ms) per 1000 neonates.
  • Analysis of QTc normalization, LQTS diagnosis, and SIDS outcomes in included studies.

Main Results:

  • Incidence of prolonged QTc varied widely based on QTc cutoff values (>450 ms, >460 ms, >470 ms).
  • QTc normalization occurred in 57.1%–95.2% of neonates with prolonged QTc.
  • Only 0.04% of neonates were diagnosed with LQTS; prolonged QTc was noted in SIDS cases.

Conclusions:

  • Neonatal ECG screening for prolonged QTc yields highly variable incidence rates.
  • A small fraction of neonates with prolonged QTc are ultimately diagnosed with LQTS.
  • Standardized research factors and genetic analysis are crucial to define the utility of neonatal ECG screening for LQTS.
Abstract

Keywords:
Cost-effectivenessECGEpidemiologyLQTSMortalitySIDSScreening

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