Electrocardiogram screening of infants for long QT syndrome: survey of pediatric cardiologists in North America

Objectives

The aim of this study was to evaluate current opinions toward screening infants for long QT syndrome (LQTS) by electrocardiogram (ECG) among pediatric cardiologists in North America.

Background

Research from Italy shows that ECG screening of infants for LQTS is cost-effective.

Methods

E-mail invitations were sent to 1045 pediatric cardiologists in North America listed in the American Academy of Pediatrics directory. The survey was Internet-based with multiple choice questions. Two repeat e-mail reminders were sent after the initial invitation.

Results

Three sixty-three (35%) responses were returned. Among the respondents, 40% had more than 20 years of clinical experience, 32% had 10 to 20 years, 21% had 5-10 years, and 6% had less than 5 years. Thirty-one percent of respondents agreed and 41% disagreed that screening LQTS may decrease the incidence of sudden infant death syndrome. When asked if an ECG between 2 and 4 weeks of life can be used to screen newborns for LQTS, 47% agreed and 33% disagreed. To the question: “pediatricians should offer families the option of 12-lead ECG at baby's 2-week visit for detecting an uncommon but potentially lethal disease,” 27% agreed and 49% disagreed. When asked if there should be a mandate for ECG screening of all newborns, 11% agreed and 69% disagreed. The support for a mandate of ECG screening decreases with increasing number of years of experience (P = .03).

Conclusions

Most pediatric cardiologists in North America remain skeptical about ECG screening of infants for LQTS. Among pediatric cardiologists, current support for ECG screening at pediatrician's offices is low, and only 10% would agree to a mandate for ECG screening.