Comparative Evaluation of Corrected QT and Ionized Calcium in Children

  • Zarrin Keihani Douste Department of Pediatric Neurology, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Mohhamad Taghi Haghi Ashtiani Department of Pathology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Mamak Shariat Mail Family Health Institute, Maternal Fetal Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Fatemeh Tehrani Family Health Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
QTc, Ionized Calcium, Total serum calcium, Convulsion


Convulsion is one of the most common problems in children and hypocalcemia is one the most frequent etiological items in children’s convulsion. Corrected QT (QTc) in EKG is prolonged in hypocalcemia, so it can be a useful tool for evaluation of serum ionized calcium. In three groups (first seizure, multiple seizures, without seizure or control ) every 25 cases, QTc, serum ionized ca, total ca, ABG, and serum albumin level have been checked in the Department of Pediatrics of Imam Khomeini Hospital and outpatient department of Ahari children’s medical center in 2008. Prolonged QTc was observed in 72% of convulsive children (36 cases) but only 19% of non-convulsive children (5 cases) showed this pattern.  Ionized calcium was significantly higher in non-convulsive than convulsive groups.  There was no correlation between prolonged QTc and total serum calcium; however, this correlation with low ionized calcium was significant. QTc is an easy and rapid method for serum ionized calcium evaluation.


Johnston M. Seizures in childhood. In: Kliegman RM, Berhman RE, Jenson HB, et al, editors. Nelson’ textbook of pediatrics. 18th edition. Philadelphia: Saunders Elsevier Can 2007; p. 2457

Frank Y. Ashwa S. Neurologic disorders associated with the gastrointestinal disease. Nutritional deficiencies and fluid electrolyte disorders. In: Swainnan KF, Ashwal S, Ferroiero MD, editors. Pediatric Neurology Principles and Practice. 4th ed. Philadelphia; Mosby Elsevier Co; 2006; p.2327-8.

Rasmussen H. The calcium messenger system. N Engl J Med 1986;314(17):1904-101.

Soniel Kumar MR, Gupta BK. Prognostic implication of hypocalcemia and QTc interval in malaria. Indian J Malariol 2000;37(3-4):61-7.

Huang TC, Cechin FC, Mahoney P, et al. Corrected QT interval prolongation and syncope associated with pseudo hypoparathyroidism and hypocalcemia. J Pediatr 2000;136(3);404-7.

Kurosu M, Ando Y, Akimoto T, et al. Factors related to the QT prolongation in chronic renal failure. Nihon Jinzo Gakkai Shi 1999;41(2):70-6.

Azarfar A. Comparative evaluation between total calcium serum and prolonged corrected QT interval.

Sinert R, Zehtabchi S, Desai S, et al. Serum ionized magnesium and calcium levels in adult patients with seizures. Scand J Clin Lab Invest 2007;67(3):317-26.

Thomas TC, Smith JM, White PC, et al. Transient Neonatal Hypocalcemia: Presentation and Outcomes.= Pediatrics 2012;129(6):e1461-7.

Visudhiphan P, Visudtibhan A, Chiemchanya S, et al.nNeonatal seizures and familial hypomagnesemia with secondary hypocalcemia. Pediatr Neurol 2005;33(3):202-5.

Lynch BJ, Rust RS. Natural history and outcome of neonatal hypocalcemic and hypomagnesemic seiures. Pediatr Neurol 1994;11(1)23-7.

Bellazzini MA, Howes DS. Pediatric hypocalcemic seiures: A case of Rickets. J Emerg Med 2005;28(2):161-4.

Sadrnia S, Yousefi P, Jalali L. Correlation between seizure in children and prolonged QT interval. ARYA Atheroscler 2013;9(1):7-10.

Jha OP, Khurana DS, Carvalho KS, et al. Assessment of the QT interval in the electroencephalography (EEG) of children with syncope, epilepsy, and attention-deficit hyperactivity disorder (ADHD). J Child Neurol 2010;25(3):284-6.

Bednar M, Harrigan EP, Anziano R, et al. The QT Interval. Prog Cardiovasc Dis 2001;43(5 Suppl 1):1-45.

Moseley B, Bateman L, Millichap J, et al. Autonomic epileptic seizures, autonomic effects of seizures, and SUDEP. Epilepsy Behav 2013;26(3):375-85.

How to Cite
Keihani Douste Z, Haghi Ashtiani MT, Shariat M, Tehrani F. Comparative Evaluation of Corrected QT and Ionized Calcium in Children. Acta Med Iran. 53(9):579-581.
Original Article(s)