Supraventricular tachyarrhythmias during the intrauterine, neonatal, and infant period: A 10‐year population‐based study

Abstract

BackgroundWe aimed to evaluate the incidence, type, and management of supraventricular tachyarrhythmias (SVT) during the first year of life in a retrospective, population‐based, single‐center study during a 10‐year period.MethodsThe analyzed patient cohort is based on data from the only specialized center managing all cases of neonatal and infant SVTs between 2009 and 2018 in the Slovak Republic (5.5 million population). A total of 116 consecutive patients <366 days old were included in the study.ResultsCalculated SVT incidence ratio was 1:4500 in the first year of life. AV reentry tachycardia was the leading arrhythmia (49%). SVT in this specific population was frequently a transient problem with spontaneous resolution in 87% of patients during a median 3‐year follow up. Congenital heart disease was common (16%). Intrauterine treatment by drugs administered to mother was safe and effective in preventing unnecessary cesarean deliveries. In arrhythmia termination, amiodarone and propafenone were equally safe and effective, with possible more favorable pharmacodynamics of the former. For prophylactic treatment, sotalol and propafenone were equally safe and effective and became the preferred basis of long‐term drug therapy in our center. However, this therapy requires intensive monitoring during its initiation.ConclusionThe prognosis of SVT in the first year of life is good: with optimized pharmacological treatment, the need for early catheter ablation and mortality rate are low (<1%) and there is a high rate of spontaneous arrhythmia resolution. Heart failure is a possible predictor of arrhythmia persistence with need for ablation in later life.

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

“…In the series of Bjelosevic consisting of 116 cases, AVRT was reported as 70% (49% concealed, 18% WPW, and 3% PJRT), FAT (23%), AF (6%), and congenital JET (1%). [11] Similarly, in our study, the most common arrhythmia types were AVRT (45%) and FAT (27%).…”

“…In addition, different authors have suggested that heart failure findings may be associated with a rate of 34-48%. [10,11] In the present study, the incidence of SVT and CHD was 32% and the rate of the left ventricular dysfunction on echocardiography was 25%.…”

“…Antiarrhythmics such as sotalol, propafenone, digoxin, propranolol, amiodarone, and flecainide were administered as monotherapy or in combination. [11,14] While propranolol or amiodarone were the most preferred medications as monotherapy, regarding the use of combined medications, we prefer the combination of propranolol and amiodarone the most.…”

Clinical and genetic spectrum of neonatal arrhythmia in a NICU

“…SVT was the second most common arrhythmia in this cohort, after premature beats. As reported, SVT is the most common arrhythmia in infants, and the incidence of SVT requiring inpatient care ranges from 1:4,500-1:5,000 in the first year of life (14)(15)(16). Persistent SVT can cause heart failure, so it should be identified and treated as soon as possible.…”

Neonatal Supraventricular Tachycardia: Outcomes Over a 10-Year Period at a Single Institution

“…In this study, the rate of ASD was lower than in our study. In Bjeloševič et al's study of 116 cases of newborns with SVT, the rate of admission to the hospital on the first day was 28% 11 . In our study, 52% of the patients were admitted to the hospital on the first day of life.…”