Newborns Hospitalized in Pediatric Cardiac Intensive Care Unit due to Supraventricular Tachyarrhythmia: A Single Center Experience

Abstract

Objective: Tachyarrhythmias are frequently observed arrhythmias in newborns. This study aimed to evaluate infants hospitalized due to supraventricular tachyarrhythmia (SVT) in our cardiac center. Materials and Methods:The study was conducted between August 01, 2020, and August 01, 2022, in neonates hospitalized in the pediatric cardiac intensive care unit due to SVT. General characteristics, echocardiographic findings, type and localization of tachyarrhythmia, and medical treatments were evaluated.Results: There were 22 cases during the study period. About 50% of the cases were male. The median age was 21 days (interquartile range [IQR] 15-27), and the median weight was 3.6 kg (IQR 3.2-4) at the time of diagnosis. The most common symptoms were restlessness in 50% (n = 11) and rapid breathing in 30% (n = 7). Tachyarrhythmia was detected during a routine examination in six cases and during fetal echocardiography in two cases. Left ventricular dysfunction was present on echocardiography in four patients initially. Congenital heart disease (CHD) was detected in four patients and cardiac tumor in two patients. Arrhythmia mechanisms were atrioventricular reentry tachycardia (n = 10), four of them were Wolff-Parkinson-White syndrome, and two of them were permanent junctional reciprocating tachycardia, focal atrial tachycardia (n = 6), atrial flutter (n = 4), and congenital junctional ectopic tachycardia (n = 1). Radiofrequency catheter ablation was performed in one patient due to resistance to medical treatment and left ventricular dysfunction. Conclusion:SVTs are the leading cause of arrhythmias in newborns and the majority of them originate from the accessory pathway. Neonatal patients should be investigated for CHD and cardiac rhabdomyoma and if these conditions are detected, multiagent treatment should be considered in prophylactic medical therapy.