Electrocardiographic findings in children and adolescents treated with antipsychotics: a cohort study
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By
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April 20, 2026
Objective:
To analyze the frequency, persistence, and clinical relevance of ECG abnormalities, particularly QTc interval prolongation, in pediatric and adolescent patients treated with antipsychotics, highlighting the potential impact on clinical monitoring strategies.
Key Findings:
- 195 of 429 patients (45.5%) exhibited at least one numeric ECG abnormality, primarily heart rate abnormalities, which may have clinical significance.
- QTc prolongation above sex-specific thresholds was observed in 24 patients (5.6%), with persistence in only 5 cases (20.8%).
- No patients had QTc ≥500 ms or clinically significant cardiac events, indicating a low risk profile.
Interpretation:
ECG abnormalities during antipsychotic treatment were common but mostly mild and transient, with QTc prolongation being rare and not linked to adverse cardiac outcomes, suggesting a need for tailored monitoring strategies.
Limitations:
- Single-center study may limit generalizability.
- Potential for selection bias in patient inclusion, and confounding factors were not fully controlled.
Conclusion:
Findings support a selective, risk-based approach to ECG monitoring in youth treated with antipsychotics, emphasizing the need for targeted strategies rather than routine universal screening.
