Assessment of Cardiac Arrhythmia Risk in Children with Multisystem Inflammatory Syndrome

This study intended to investigate laboratory markers and ventricular repolarization in electrocardiograms (ECGs) of children with multisystem inflammatory syndrome (MIS-C).

Children with MIS-C from a single center were included. The study was conducted from January 27, 2022, to January 1, 2023. Basal ECGs, taken at the beginning (before treatment), were evaluated. The 12-lead ECG parameters, QT, QTc, T-peak to T-end (TpTe) distances, TpTe dispersion, and TpTe/QT ratio were compared with the healthy control group.

The QT interval, QTc duration, Tp-e distance, Tp-e dispersion, and Tp-e/QTc ratio were prominently higher in the patient group. Cardiac troponin I, NT-proBNP, D-dimer, biochemical data, CRP, and sedimentation also increased in these patients. In the severe MIS-C group, Tp-e dispersion duration was longer than in the mild MIS-C group (P = 0.04). QT duration was positively correlated with troponin I. The D-dimer level was positively correlated with the length of hospitalization of the patients.

These results suggest that MIS-C has a significant effect on repolarization, which could lead to lethal arrhythmia, including QT prolongation and ventricular tachycardia. These ECG changes may be strongly related to the prognosis and could help physicians decide which patients might have the risk of lethal arrhythmias.