Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
Circ Arrhythm Electrophysiol. 2013 Oct;6(5):932-8. doi: 10.1161/CIRCEP.113.000619. Epub 2013 Sep 13.
Neonatal electrocardiographic screening is used to screen infants with prolonged QT intervals, as previously shown in whites. However, this procedure needs to be confirmed in other ethnic groups.
In 8 areas in Japan, an ECG was recorded in 4285 infants at 1-month medical checkup. A prospective study showed that a provisional criterion of QTc≥470 ms was appropriate for infants. To assess the validity of the criterion, all infants with a QTc between 460 and 470 ms were followed up. Five infants had a QTc≥470 ms. Four infants were diagnosed with prolonged QT intervals from follow-up ECGs. Four infants showed no symptoms and did not have a family history of long-QT syndrome. Two infants showed progressive prolongation of QT intervals, and medication was started. Genetic testing was performed in 3 of 4 infants with prolonged QT intervals, and it revealed a KCNH2 mutation (3065 delT, L1021fs+34X) in 1 infant. One infant with a QTc≥470 ms and 2 infants with a QTc between 460 and 470 ms showed a decline in their QTc values during follow-up. The study screened another infant with Wolff-Parkinson-White syndrome who was diagnosed with noncompaction before symptoms appeared.
Neonatal electrocardiographic screening can identify infants likely to be affected by long-QT syndrome in the Japanese population, as already shown in whites. This screening may also be useful in identifying other important cardiac diseases.
新生儿心电图筛查用于筛查 QT 间期延长的婴儿，此前在白种人中已有研究显示。然而，这一程序需要在其他种族中得到证实。
在日本的 8 个地区，在婴儿 1 个月的体检中记录了 4285 名婴儿的心电图。一项前瞻性研究表明，Qtc≥470ms 的暂定标准适用于婴儿。为了评估该标准的有效性，对所有 QTc 在 460-470ms 之间的婴儿进行了随访。有 5 名婴儿的 QTc≥470ms。5 名婴儿中有 4 名被诊断为 QT 间期延长。4 名婴儿没有症状，也没有长 QT 综合征的家族史。其中 2 名婴儿的 QT 间期逐渐延长，开始药物治疗。对 4 名 QT 间期延长的婴儿中的 3 名进行了基因检测，其中 1 名婴儿发现 KCNH2 突变（3065delT，L1021fs+34X）。1 名 QTc≥470ms 的婴儿和 2 名 QTc 在 460-470ms 之间的婴儿在随访期间 QTc 值下降。该研究还筛查了另一名患有预激综合征的婴儿，该婴儿在出现症状前被诊断为非致密化心肌病。
新生儿心电图筛查可以识别日本人群中可能患有长 QT 综合征的婴儿，这与白人中的研究结果一致。这种筛查也可能有助于识别其他重要的心脏疾病。
