Qtc interval prolongation and severe apneas associated with a change in infant positioning

Marc A. Ellsworth, Timothy J. Ulrich, William A. Carey, Christopher E. Colby, Michael J. Ackerman

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

For more than a decade there has been considerable interest in the role of QT interval prolongation in the pathogenesis of sudden infant death syndrome. It has been proposed that the QT interval is a surrogate marker for autonomic instability and can be used to identify infants at risk for significant morbidity and mortality, including sudden infant death syndrome. We present the case of an infant that experienced a significant increase in his QTc, as detected by continuous QTc monitoring in the NICU after repositioning from a supine to prone position. This increase from a 413 ± 6 millisecond baseline average to 500 milliseconds was sustained for 2 hours and associated with clinically relevant apnea that ultimately required repositioning of the infant back to the supine position. Repositioning resulted in an immediate decrease of the QTc back to the previous baseline and termination of the apneic events. This case demonstrates an example of how the use of continuous QTc monitoring in the NICU setting may be used to detect QTc-accentuating factors in real time and identify situations that cause perturbations in an infant's autonomic nervous system.

Original languageEnglish (US)
Pages (from-to)e1690-e1693
JournalPediatrics
Volume132
Issue number6
DOIs
StatePublished - Dec 2013

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Keywords

  • Apnea
  • Autonomic nervous system
  • Electrocardiography
  • Infants
  • NICUs

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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