Taquiarritmias supraventriculares no feto. Experiência de uma unidade de referência em cardiologia fetal

Zielinsky, Paulo; Dillenburg, Rejane; Lima, Gustavo Glotz de; Zimmer, Leonardo

doi:10.1590/s0066-782x1998000500006

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…Atrial arrhythmias in particular are reported more frequently in newborns with congenital heart disease 5,6. In a study of 21 arrhythmic newborns, Satar et al 7 found a congenital heart disease rate of 38%, while Canpolat et al 8 reported a rate of 23.1%.…”

Section: Discussionmentioning

confidence: 98%

Diagnosis, treatment and follow up of neonatal arrhythmias : cardiovascular topic

Binnetoğlu

Babaoğlu

Turker

et al. 2014

CVJA

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SummaryObjectiveThis study aimed to evaluate the aetiology, spectrum, course and outcomes of neonates with arrhythmias observed in a tertiary neonatal intensive care unit from 2007 to 2012.MethodsNeonates with rhythm problems were included. The results of electrocardiography (ECG), Holter ECG, echocardiography and biochemical analysis were evaluated. The long-term results of follow up were reviewed.ResultsForty-five patients were male (68%) and 21 (32%) were female. Fifty-five patients (83.3%) were term, 11 (16.6%) were preterm, and 34% were diagnosed in the prenatal period. Twenty cases (30.3%) had congenital heart disease. Twenty-three patients (34.8%) were diagnosed during the foetal period. The most common arrhythmias were supraventricular ectopic beats and supraventricular tachycardia (SVT) at 39.3 and 22.7%, respectively. SVT recurred in five patients after the neonatal period.ConclusionSupraventricular ectopic beats and SVT were the most common arrhythmias during the neonatal period. Although the prognosis of arrhythmias in the neonatal period is relatively good, regular monitoring is required.

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Section: Discussionmentioning

confidence: 98%

Diagnosis, treatment and follow up of neonatal arrhythmias : cardiovascular topic

Binnetoğlu

Babaoğlu

Turker

et al. 2014

CVJA

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“…1 6 12 SVT was associated with Ebstein's anomaly (n = 2) and ventricular septal defect (n = 2). 11 Outcome At birth 50% of fetuses with atrial flutter (23 of 46) were in sinus rhythm 1 5 10-12 compared with 71.4% of fetuses with SVT (65 of 91). 5 10-13 Because of the small numbers this difference was not significant.…”

Section: Association With Congenital Heart Defectsmentioning

confidence: 99%

Review of diagnosis, treatment, and outcome of fetal atrial flutter compared with supraventricular tachycardia

Krapp

2003

Heart

172

118

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Objective: To review the diagnosis, treatment, and outcome of fetal atrial flutter compared with supraventricular tachycardia. Design: Retrospective review of published reports: 11 papers about fetal tachyarrhythmia published between 1991 and 2002 were selected for review. Main outcome measures: All selected studies were analysed for the type of arrhythmia, degree of atrioventricular block in atrial flutter, occurrence of hydrops fetalis, gestational age at diagnosis, first and second line drug treatment, associated cardiac and extracardiac malformations, and mortality of the fetuses. Results: Atrial flutter accounted for 26.2% of all cases of fetal tachyarrhythmias, and supraventricular tachycardia for 73.2%. Hydrops fetalis was reported in 38.6% and 40.5% of fetuses with atrial flutter and supraventricular tachycardia, respectively (NS). Hydropic fetuses with atrial flutter had higher ventricular rates (median 240 beats/min, range 240-300) than non-hydropic fetuses (220 beats/min, range 200-310) (p = 0.02), whereas the atrial rates were not significantly different (median 450 beats/min, range 370-500). Digoxin treatment resulted in a higher conversion rate in non-hydropic fetuses with fetal tachyarrhythmias than in hydropic fetuses (p < 0.001). The overall mortality of atrial flutter was similar to that of supraventricular tachycardia, at 8.0% v 8.9% (p = 0.7). Conclusions: The prevalence of hydrops fetalis did not differ in fetal atrial flutter and supraventricular tachycardia with 1:1 conduction. There was no difference between the response rate to digoxin in fetus with atrial flutter or supraventricular tachycardia. Mortality was similar in the two types of tachyarrhythmia.A ccording to published reports, atrial flutter accounts for a fifth to a third of all fetal tachyarrhythmias. 1 2 Fetal atrial flutter is defined as a rapid regular atrial rate of 300-600 beats/min accompanied by variable degrees of atrioventricular (AV) conduction block, resulting in slower ventricular rates. Previous data have suggested that fetal atrial flutter carries a worse prognosis than fetal supraventricular tachycardia (SVT) with 1:1 AV conduction, because of difficulties in controlling this rhythm disorder and the likelihood of associated congenital cardiac malformations.3 In contrast, Simpson and Sharland recently reported that the outcome of fetal tachyarrhythmias depends on the presence or absence of hydrops fetalis but not on the type of arrhythmia.2 Our aim in the present study was to review the diagnosis, treatment, and outcome of fetal atrial flutter compared with SVT. METHODS Study populationFor the review, data were collected from publications about fetal tachyarrhythmias published from 1990 onwards. Eleven papers about fetal tachyarrhythmia 1 2 4-12 were selected from the Medline database according to the following criteria:• only articles with more than 10 cases of fetal tachyarrhythmia were included • all publications had to contain data about consecutive cases of fetal tachyarrhythmia.• articles dealing with isola...

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“…[14,16] The incidence of congenital heart disease in newborns diagnosed with SVT is reported as 6.5%-37%. [12,13,[17][18][19] In our study, frequency of structural heart disease was 39.2%. In decreasing order of frequency, the accompanying heart diseases were as follows: ASD (21.7%), PDA (6.5%), VSD (6.5%), c-TGA (2.1%) and tricuspid atresia (2.1%).…”

Section: Discussionmentioning

confidence: 73%

Management of neonatal supraventricular tachycardias; A single center experience

Epçaçan¹

2019

EJMI

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The incidence of neonatal arrhythmias is reported as 1-5%. [1, 3, 4] Neonatal arrhythmias are classified as benign and nonbenign arrhythmias and have various clinical manifestations. Supraventricular tachycardia (SVT), ventricular tachycardia (VT), atrioventricular conduction disorders and genetic disorders such as long QT syndrome are classified as non-benign arrhythmias. [1, 4, 5] Supraventricular tachycardia is the most common non-benign tachycardia among neonates, and reentry tachycardia via accessory pathway is the most common SVT in neonates and infants. [6, 7] Clinical manifestations of the tachycardia mainly depends on the heart rate and urgent diagnosis and accurate treatment is very crucial because the tachycardia may lead to life threating conditions such as hypotension, heart failure and shock. [8] A regular heart rate of >220/beats per minute, absent or altered axis P waves, and a QRS complex with a duration of <0.08 ms (unless aberrant conduction is present) are the typical ECG findings of supraventricular tachycardia. [9] Treatment of SVT is classified into three: 1) Abortive treatment, 2) Acute treatment 3) Secondary prevention or prophylactic treatment to prevent recurrence. [10, 11] The aim of this study is to evaluate the newborns diagnosed with supraventricular tachycardia in means of diagnosis, treatment, and follow-up. Objectives: Emergent treatment of neonatal supraventricular tachycardia (SVT) is very crucial because it may lead to life threating conditions. The aim of this study is to evaluate the neonatal SVTs. Methods: Neonates, who were diagnosed with SVT between December 2014 and May 2018, were analyzed. Clinical findings, electrocardiogram (ECG) and echocardiography findings, 24-hour Holter ECG recordings and medications were evaluated. Results: 46 over 1932 newborns were diagnosed with SVT. 76% of patients were common SVT with narrow QRS and short RP, 13% with Wolff-Parkinson-White syndrome, 4.3% with multifocal atrial tachycardia, 4.3% with atrial flutter, 2.1% with permanent reciprocating junctional tachycardia. Adenosine terminated SVT in 84.4% of the cases. Synchronized cardioversion was performed in 10.8% cases. Amiodarone and/or esmolol for acute treatment was used in 39.1%. Propranolol, digoxin, amiodarone, propafenone and flecainide were the drugs used for monotherapy or combination therapies. Conclusion: In patients with initially unresponsive to standard dose of adenosine and under acute treatment with amiodarone and/or emolol continuous infusion, higher doses of adenosine (300-500 µg/gr/kg) is very effective. Amiodarone alone and in combination with flecainide seems safe and effective.

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Taquiarritmias supraventriculares no feto. Experiência de uma unidade de referência em cardiologia fetal

Abstract: Fetal supraventricular tachyarrithmias are rare in the general population. Nevertheless, the fetus may present with severe heart failure and death. Considering the satisfactory therapeutic response, accurate diagnosis and early treatment of these conditions are extremely important.

Cited by 11 publications

References 10 publications

Diagnosis, treatment and follow up of neonatal arrhythmias : cardiovascular topic

Diagnosis, treatment and follow up of neonatal arrhythmias : cardiovascular topic

Review of diagnosis, treatment, and outcome of fetal atrial flutter compared with supraventricular tachycardia

Management of neonatal supraventricular tachycardias; A single center experience

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