Abstract
BackgroundLimited data about arrhythmias in neonates and infants are coming out from the Middle East.ObjectivesTo evaluate different types of arrhythmias in neonates and infants at the American University of Beirut Medical Center (AUBMC), a tertiary care center in Lebanon, with the focus on the nature of arrhythmia, treatment modalities and relation to surgery.MethodsData were collected retrospectively from the hospital records. We included all neonates and infants presenting to AUBMC between 2013 and 2017. Collected data included: the type of arrhythmia, the treatment modality used and its success, the need for additional modes of treatment, the relationship to congenital heart diseases, and the cardiac surgeries performed.ResultsOf 16,346 subjects admitted to AUBMC between 2013 and 2017, 90 subjects developed arrhythmias that required medical intervention. The most frequent types of arrhythmias were supraventricular tachycardia (62.22%), junctional ectopic tachycardia (13.33%), complete heart block (7.78%), atrial flutter (5.56%), multifocal atrial tachycardia (3.33%), Wolf Parkinson White Syndrome (3.33%), non-sustained ventricular tachycardia (2.22%), sinus pause (1.11%), and premature ventricular contractions (1.11%). Bivariate analysis showed a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in terms of the type of arrhythmia developed, the presence of congenital heart defect, prematurity, and electrolyte disturbances (P-value <0.005). However, multivariate logistic regression showed no significant difference between the two groups after adjustment for the significant variables (P-value > 0.05).ConclusionThere is a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in neonates and infants at AUBMC. However, the difference disappears after adjusting for different variables.
Highlights
Arrhythmias in neonates and infants are seen worldwide with an incidence of 24.4 per 100,000 live births, with supraventricular tachycardia being the most common [1]
Of 16,346 subjects admitted to American University of Beirut Medical Center (AUBMC) between 2013 and 2017, 90 subjects developed arrhythmias that required medical intervention
Bivariate analysis showed a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in terms of the type of arrhythmia developed, the presence of congenital heart defect, prematurity, and electrolyte disturbances (P-value
Summary
Arrhythmias in neonates and infants are seen worldwide with an incidence of 24.4 per 100,000 live births, with supraventricular tachycardia being the most common [1] These arrhythmias might be idiopathic or associated with several risk factors, including congenital cardiac anomalies, surgical procedures, prematurity, immunologic or iatrogenic causes [2]. Some of these arrhythmias may be benign; if left untreated, some might lead to thrombi, hemodynamic instability, cardiovascular collapse, or even death, with earlier reports showing infant mortality of 8% [3] to 16% [4] in some cases. Limited data about arrhythmias in neonates and infants are coming out from the Middle East
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