RESUMEN
Introducción: El síndrome de QT largo congénito es una entidad poco frecuente y sin embargo causante de cerca del 10% de las muertes súbitas del lactante. Se caracteriza por un intervalo QT prolongado en el electrocardiograma (ECG) basal que asocia episodios de arritmias potencialmente mortales, en general en pacientes previamente asintomáticos, que son prevenibles con un tratamiento adecuado. Objetivos: Estudiar el impacto de la implementación de un screening electrocardiográfico en neonatos y obtener los valores de referencia en nuestra población. Material y métodos: Se realizó un ECG de 12 derivaciones. Medidas: intervalos RR, PR, QT y QT corregido; amplitud de R (V1, AVR y AVL), de Q (I y aVL), amplitud y duración de la onda P; morfología de bloqueo de rama derecha con elevación del ST (patrón Brugada); onda delta. Se consideraron patológicos: QT corregido > 0,44 o < 0,30 segundos; R en V1 > 12 y en aVR >8mm; R en aVL > 7,5mm; Q > 25% QRS (I y aVL), patrón Brugada y onda delta. Resultados: Nacieron 1.061 niños sanos en nuestro hospital entre el 29 de mayo de 2007 y el 12de diciembre de 2008, 50,3% varones. Se realizó ECG a 1.006 (asistencia del 94,8%). Cinco fueron patológicos (0,5%): 2 QT largos (no confirmados en estudio posterior), 2 Wolf-Parkinson-Whitey 1 onda Q patológica. No se encontró cardiopatía estructural en ninguno de ellos. Conclusiones: El cribado electrocardiográfico en neonatos es una prueba inocua, económica y bien aceptada por los padres que permite diagnosticar patología cardíaca asintomática pero potencialmente mortal, y se obtienen con dicho cribado las principales medidas electrocardiográficas en nuestra población (AU)
Introduction: Congenital long QT syndrome is a rare disease, but is responsible for nearly 10%of Sudden Infant Death Syndrome. It is characterized by an abnormal prolonged QT interval in the basal electrocardiogram (ECG) with life-threatening arrhythmias which occur in previously asymptomatic patients and are preventable with an appropriate treatment. Aims: The impact of introducing ECG-screening in newborns is studied and main ECG measurements are described in our population. Material and methods: Twelve-lead ECG was carried out. Measurements: RR, PR and QT interval, heart rate corrected QT interval, R wave voltage in V1, AVR and AVL, Q wave in I and AVL, P amplitude and voltage, right bundle branch block and ST elevation (Brugada pattern) and delta wave. It was considered pathological: QTc >0.44 or <0.30 seconds; R >12 in V1 and >8mm in AVR; R >7.5mm in AVL; Q >25% QRS in I and AVL; Brugada pattern; delta wave. Results: A total of 1061 healthy children were born in our hospital between 29 May 2007 and 12 December 2008, of which 50.3% were males. An ECG was performed on 1006 (94.8%). Five ECG were pathological (0.5%): 2 long QT interval, 2 Wolf-Parkinson-White, 1 pathological Q-wave. A second ECG confirmed except for 2 long QT. No structural heart disease was found. Conclusions: ECG-screening in newborns is an innocuous, low-cost and parent-well-accepted test that allows us to diagnose asymptomatic but potentially lethal and preventable heart disease; main intervals and waves in our population are describes in this study (AU)
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Tamizaje Neonatal/métodos , Electrocardiografía/métodos , Cardiopatías Congénitas/epidemiología , Muerte Súbita del Lactante/epidemiología , Síndrome de QT Prolongado/epidemiologíaRESUMEN
INTRODUCTION: Congenital long QT syndrome is a rare disease, but is responsible for nearly 10% of Sudden Infant Death Syndrome. It is characterized by an abnormal prolonged QT interval in the basal electrocardiogram (ECG) with life-threatening arrhythmias which occur in previously asymptomatic patients and are preventable with an appropriate treatment. AIMS: The impact of introducing ECG-screening in newborns is studied and main ECG-measurements are described in our population. MATERIAL AND METHODS: Twelve-lead ECG was carried out. MEASUREMENTS: RR, PR and QT interval, heart rate corrected QT interval, R wave voltage in V1, AVR and AVL, Q wave in I and AVL, P amplitude and voltage, right bundle branch block and ST elevation (Brugada pattern) and delta wave. It was considered pathological: QTc >0.44 or <0.30 seconds; R >12 in V1 and >8mm in AVR; R >7.5mm in AVL; Q >25% QRS in I and AVL; Brugada pattern; delta wave. RESULTS: A total of 1061 healthy children were born in our hospital between 29 May 2007 and 12 December 2008, of which 50.3% were males. An ECG was performed on 1006 (94.8%). Five ECG were pathological (0.5%): 2 long QT interval, 2 Wolf-Parkinson-White, 1 pathological Q-wave. A second ECG confirmed except for 2 long QT. No structural heart disease was found. CONCLUSIONS: ECG-screening in newborns is an innocuous, low-cost and parent-well-accepted test that allows us to diagnose asymptomatic but potentially lethal and preventable heart disease; main intervals and waves in our population are describes in this study.