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Paper Chase

Altered cardiac repolarization in some victims of sudden infant death syndrome.

N. Engl. J. Med.. Dec 10, 1987;317(24):1501-5.
Sadeh D, Shannon DC, Abboud S, Saul JP, Akselrod S, Cohen RJ.

Harvard-MIT Division of Health Sciences and Technology, Massachusetts General Hospital, Boston 02114.


Abnormal prolongation of cardiac repolarization, as reflected by a long QT interval with respect to the RR interval on the electrocardiogram, is known to be associated with ventricular tachyarrhythmias. To test the hypothesis that prolonged cardiac repolarization may characterize some babies who die of sudden infant death syndrome (SIDS), we studied the dependence of the QT interval on the preceding RR interval in 10 babies with SIDS and 29 healthy control babies. We analyzed approximately 5000 pairs of QT and RR intervals in each subject over a wide range of RR intervals. We found that the QT intervals demonstrated less dependence on the preceding RR intervals in 5 of 10 babies who subsequently died of SIDS than in normal controls. No ventricular arrhythmias were observed, however, during the six-hour recording period. Our data suggest that in some babies with SIDS the ability to shorten the QT interval as the heart rate increases is impaired. These observations are consistent with the hypothesis that relatively prolonged cardiac repolarization may predispose such babies to ventricular arrhythmias.