Measures of cardiac repolarization and body position in infants

Sherri S. Baker, Norman S. Talner, Angelo S. Milazzo, Stephen P. Sanders, Anne Marie Valente, Ronald J. Kanter, Ian M. Paul, Jennifer S. Li

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Sudden Infant Death Syndrome (SIDS) is the most common cause of death in children between 1 and 6 months of age. Recent data suggest that a prolonged QTc interval on the 12-lead electrocardiogram (ECG) is associated with SIDS. Prone body position during sleep is also known to be a risk factor for SIDS; this has prompted the American Academy of Pediatrics to promote the "Back to Sleep" campaign. We postulated that the QTc interval in infants might change as a function of body position, linking the observations relating body position and QTc interval to SIDS. We recorded ECGs in a group of infants in both the supine and prone position to determine if the QTc interval and QT dispersion differ between the 2 positions. Forty-seven standard 12-lead ECGs and high-amplitude, rapid-sweep 12-lead ECGs were performed on 45 healthy infants (mean age 26 ± 40 days) in both the supine and prone positions. The infants were asleep in a quiet, restful state. The ECGs were reviewed by 2 investigators blinded to the position of the infants during recording. Measurements included the average QTc interval (using Bazett's correction) and QT dispersion (the difference between the longest and the shortest QT intervals on a standard 12-lead EKG). The study was designed to detect a 3% difference in QTc interval with 80% power and α=0.05. All subjects had telephone or clinical follow-up at 1 year. The average QTc interval was 403 ± 20 milliseconds (msec) in the supine position and 405 ± 27 msec in the prone position (p=NS). The QT dispersion was 20 ± 12 msec in the supine position and 22 ± 13 msec in the prone position (p=NS). One infant in the study group died of SIDS at the age of 3 months. The ECG of this patient revealed a QTc interval of 382 msec in the supine position and 407 msec in the prone position; the QT dispersion was 34 msec in the supine position and 34 msec in the prone position. We found no difference in QTc interval or QT dispersion as a function of body position in healthy infants resting quietly. Prolongation of the QTc interval is unlikely to explain the increased risk for SIDS associated with prone body position in the general population of healthy infants, unless patients with long QT syndrome are somehow more influenced by body position than normal patients are.

Original languageEnglish (US)
Pages (from-to)67-70
Number of pages4
JournalClinical Pediatrics
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2003

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Prone Position
Sudden Infant Death
Supine Position
Electrocardiography
Sleep
Long QT Syndrome
Telephone
Cause of Death
Research Personnel
Pediatrics
Lead

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Baker, S. S., Talner, N. S., Milazzo, A. S., Sanders, S. P., Valente, A. M., Kanter, R. J., ... Li, J. S. (2003). Measures of cardiac repolarization and body position in infants. Clinical Pediatrics, 42(1), 67-70. https://doi.org/10.1177/000992280304200110
Baker, Sherri S. ; Talner, Norman S. ; Milazzo, Angelo S. ; Sanders, Stephen P. ; Valente, Anne Marie ; Kanter, Ronald J. ; Paul, Ian M. ; Li, Jennifer S. / Measures of cardiac repolarization and body position in infants. In: Clinical Pediatrics. 2003 ; Vol. 42, No. 1. pp. 67-70.
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Baker, SS, Talner, NS, Milazzo, AS, Sanders, SP, Valente, AM, Kanter, RJ, Paul, IM & Li, JS 2003, 'Measures of cardiac repolarization and body position in infants', Clinical Pediatrics, vol. 42, no. 1, pp. 67-70. https://doi.org/10.1177/000992280304200110

Measures of cardiac repolarization and body position in infants. / Baker, Sherri S.; Talner, Norman S.; Milazzo, Angelo S.; Sanders, Stephen P.; Valente, Anne Marie; Kanter, Ronald J.; Paul, Ian M.; Li, Jennifer S.

In: Clinical Pediatrics, Vol. 42, No. 1, 01.01.2003, p. 67-70.

Research output: Contribution to journalArticle

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AU - Baker, Sherri S.

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Baker SS, Talner NS, Milazzo AS, Sanders SP, Valente AM, Kanter RJ et al. Measures of cardiac repolarization and body position in infants. Clinical Pediatrics. 2003 Jan 1;42(1):67-70. https://doi.org/10.1177/000992280304200110