Electrocardiographic findings in paediatric patients with rheumatic diseases using hydroxychloroquine

To evaluate the prevalence and clinical implications of QT interval prolongation and other electrocardiographic changes in paediatric patients with rheumatic diseases using hydroxychloroquine.

This was a retrospective and prospective, observational, and analytical study conducted at a centre of perinatology and paediatrics in Rio de Janeiro, Brazil. A total of 26 evaluations of patients ≤18 years old on hydroxychloroquine were included, all following paediatric rheumatology and cardiology services. Patients were included if they had been receiving hydroxychloroquine for at least six months and had complete clinical records; those with pre-existing cardiac conditions unrelated to hydroxychloroquine were excluded. Clinical, demographic, and electrocardiographic data were collected from medical records using standardised protocols.

The corrected QT interval was manually measured on 12-lead electrocardiograms and analysed in relation to cumulative drug dose. All electrocardiograms were reviewed independently by two cardiologists to ensure accuracy of corrected QT interval measurements, and discrepancies were resolved by consensus. Most patients were female (76.9%), and systemic lupus erythematosus was the most prevalent diagnosis (88.9%). The cumulative hydroxychloroquine dose ranged from 12 to 447.6 g (mean: 223 g). Corrected QT interval values ranged from 377 to 454 ms (mean: 413 ms). Correlation analysis between cumulative dose and corrected QT interval showed a weak negative association (r = -0.24; p = 0.338), not statistically significant. Simple linear regression confirmed no association between variables (R² = 5.7%).

In this cohort of paediatric patients with rheumatic diseases, no significant association was observed between cumulative hydroxychloroquine use and QT interval prolongation.