Autonomic Function and QT Interval During Night-Time Sleep in Infant Long QT Syndrome

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  • Yoshinaga Masao
    Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
  • Kucho Yu
    Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
  • Ushinohama Hiroya
    Pediatric Cardiology, Ohori Children’s Clinic
  • Ishikawa Yuichi
    Department of the Cardiovascular System, Fukuoka Children’s Hospital
  • Ohno Seiko
    Center for Epidemiologic Research in Asia, Shiga University of Medical Science
  • Ogata Hiromitsu
    Epidemiology and Biostatistics, Kagawa Nutrition University

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Abstract

<p>Background:Sudden infant death syndrome mainly occurs during night-time sleep. Approximately 10% of cases are thought to involve infants with long QT syndrome (LQTS). Autonomic function and QT interval in night-time sleep in early infancy in LQTS infants, however, remain controversial.</p><p>Methods and Results:Holter electrocardiography was performed in 11 LQTS infants before medication in early infancy, and in 11 age-matched control infants. Control infants were re-evaluated in late infancy. The power spectral density was calculated and parasympathetic activity and sympathovagal balance were obtained. Electrocardiograms of a representative hour during night-time sleep, daytime sleep, and daytime activity, were chosen and QT/RR intervals were manually measured. LQTS infants had significantly lower parasympathetic activity and higher sympathovagal balance during night-time sleep than control infants in early infancy. These autonomic conditions in early infancy were significantly depressed compared with late infancy. Corrected QT interval (QTc) during night-time sleep (490±20 ms) was significantly longer than that in daytime sleep (477±21 ms, P=0.04) or daytime activity (458±18 ms, P=0.003) in LQTS infants, and significantly longer than that during night-time sleep in controls.</p><p>Conclusions:A combination of the longest QTc and autonomic imbalance during night-time sleep in early infancy may be responsible for development of life-threatening arrhythmia in LQTS infants. Critical cases should be included in future studies.</p>

Journal

  • Circulation Journal

    Circulation Journal 82 (8), 2152-2159, 2018-07-25

    The Japanese Circulation Society

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