Maximum QTc on Holter electrocardiography in children

Holter Electrocardiographic Approach to Predicting Outcomes of Pediatric Patients With Long QT Syndrome

BACKGROUND

This study was performed to clarify the clinical findings of pediatric patients diagnosed with long QT syndrome (LQTS) through electrocardiographic screening programs and to predict their outcome using Holter electrocardiographic approaches.Methods and Results: This retrospective study included pediatric patients with a Schwartz score of ≥3.5 who visited the National Hospital Organization Kagoshima Medical Center between April 2005 and March 2019. Resting 12-lead and Holter electrocardiograms were recorded at every visit. The maximum resting QTc and maximum Holter QTc values among all recordings were used for statistical analyses. To test the prognostic value of QTc for the appearance of cardiac events after the first hospital visit, receiver operating characteristic curves were used to calculate the area under the curve (AUC). Among 207 patients, 181 (87%) were diagnosed through screening programs. The prevalence of cardiac events after the first hospital visit was 4% (8/207). Among QTc at diagnosis, maximum resting QTc, and maximum Holter QTc, only maximum Holter QTc value was a predictor (P=0.02) of cardiac events after the hospital visit in multivariate regression analysis. The AUC of the maximum Holter QTc was significantly superior to that of maximum resting QTc.

CONCLUSIONS

The maximum Holter QTc value can be used to predict the appearance of symptoms in pediatric patients with LQTS.

A Congenital Deadly Association: Dilated Cardiomyopathy and Long QT Syndrome

Long QT syndrome is one of the most feared entities in hospitalized patients due to the potential risk for ventricular tachycardia and sudden death. Association between channelopathies and congenital cardiomyopathy is a new entity that has been studied recently. We report an interesting case of this association that maybe related to a genetic mutation.