Circulation, Vol 66, 496-501, Copyright © 1982 by American Heart Association
PJ Schwartz, M Montemerlo, M Facchini, P Salice, D Rosti, G Poggio and R Giorgetti
A prospective electrocardiographic study was designed to establish baseline
values for electrocardiographic measurements, with specific reference to
the QT interval during infancy, and to test the "QT hypothesis" for the
sudden infant death syndrome (SIDS). In this ongoing study, ECGs are
recorded on the fourth day of life and in the second, fourth and sixth
months. The state of health at 1 year is ascertained by a phone call. So
far, 4205 newborns have been enrolled. The mean QTc (QT interval corrected
for heart rate) was 397 +/- 18 msec (+/- SD) at the fourth day, 409 +/- 15
msec (p less than 0.0001) at the second month, and 406 +/- 15 msec at the
fourth month; by the sixth month, it returned to 400 +/- 14 msec. In 88
newborns, the QTc increased by over 40 msec at the second month. Among the
2000 infants checked at 1 year, there have been three sudden and unexpected
deaths. The QTc of one of the victims at the fourth day was 563 msec, which
exceeded the mean by more than 9 standard deviations, while the QTc of the
other SIDS victims exceeded the mean by more than 2 and 3 standard
deviations. These results are consistent with the "QT hypothesis," but more
data are necessary before any conclusion on the potential relationship
between QT interval prolongation and SIDS can be drawn. This study provides
definitive waking normal values for QT interval in infancy and indicates
that the QT interval lengthens physiologically and temporarily during the
first months of life. In some infants, this lengthening may transiently
impair cardiac electrical stability.
ARTICLES
The QT interval throughout the first 6 months of life: a prospective study
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