Abstract
The aim of the study was analysis of supraventricular tachycardia (SVT) in neonates and assessment of antiarrhythmic treatment efficacy. Study population consisted of 30 neonates – 6 females (20%) and 24 males (80%), aged from first to 29 day of life (mean age 16,2 d). All pts underwent standard 12-lead ECG and 24-hour Holter monitoring. Echocardiography with structural and functional assessment was also done in all children. Results Atrioventricular re-entry tachycardia with accessory pathway was diagnosed in 10 patients (33,3%), atrioventricular nodal re-entry tachycardia (AVNTR) in 4 neonates (13,3%), atrial ectopic tachycardia (AET) in 6 pts (20%), atrial flutter in 1 child (3,3%), sinus tachycardia in decursu of tyreotoxicosis in 1 patient (3,3%). The precise diagnose of SVT was not established in 8 patients (26,7%). In study population there were 23 children (76,7%) without any cardiac pathology, congenital heart disease was diagnosed in 4 pts (13,3%) (TOF, avs, S.Ebsteini, ASDII), tumor of right atrium (Tu) in 1 patient (3,33%), persisting pulmonary hypertension of neonates (PPHN), in 1 child (3,33%) and myocarditis (MC) in 1 patient (3,33%). Congestive heart failure was present in 13 pts (43,3%) – in 10 pts (33,3%) without structural heart disease and in 3 children (10%) with cardiac pathology (Tu, PPHN, MC). In anti-arrhythmic treatment for SVT termination adenosine was applied in 18 pts (60%) and in 10 pts (33,3%) SVT was finished. SVT was terminated also with digoxin in 2 pts (6,7%), propaphenon in 2 pts (6,7%), propranolol in 1 patient (3,3%), sotalol in 1 patient (3,3%), digoxin combined with propranolol in 9 pts (30%), digoxin with sotalol in 1 patient (3,3%). Electrical cardioversion was done in 2 pts (6,7%) and in following 2 pts (6,7%) SVT resolved after maneuvers (carotic massage, cold water). Conclusions 1.Supraventricular tachycardia in newborns is frequently complicated by congestive heart failure. 2. Digoxin is still useful and effective in SVT termination therapy. 3. Risk of SVT recurrence is rather low in neonates and connected mostly with structural heart disease.
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