Zaburzenia rytmu serca u noworodków – doświadczenia własne

*Barbara Wójcicka-Urbańska, Halszka Kamińska, Agnieszka Tomik, Radosław Pietrzak

Summary
Introduction. Cardiac arrhythmias are still an important clinical problem in newborns. In this period of life, a clinical course of the heart rhythm disturbances may be miscellaneous from benign to life-threating depending on the presence of the heart failure. In that standpoint close assessment of the arrhythmia type and its consequences are crucial for the proper diagnosis and successful treatment during the follow up later in infancy.
Aim. The aim of the study was analysis of type, clinical symptoms and treatment of arrhythmias in neonates hospitalized in Department of Pediatric Cardiology, Medical University of Warsaw.
Material and methods. 26 neonates hospitalized due to arrhythmia from 01.01.2010 to 31.12.2012 were analyzed retrospectively.
Results. 18 patient were diagnosed with reciprocating supraventricular tachycardia (SVT) with heart rate 200-300 bpm, 7 – with premature extrasystole, 1 – with complete atrioventricular block. In 8 children arrhythmia was detected antenataly. Clinical symptoms of arrhythmia were noted in 6 neonates with SVT, 3 presented cardiogenic shock. In pharmacotherapy adenosine was admitted extemporaneously in patients with SVT, further medications were chosen individually, 7 neonates required combined treatment. Average hospitalization time amounted to 15 days, in patients with SVT – 19 days. Oral prophylactic pharmacotherapy was admitted in almost all cases of SVT for mean time of 7.7 months. In neonates with premature beats no treatment was required and arrhythmia resolved in time. The child with atrioventricular block has been observed for 17 months – until now was not qualified for pacemaker implantation.
Conclusions. 1. Supraventricular tachycardia with fast heart rate is the most common symptomatic arrhythmia in neonates. 2. Almost 40% of neonates with SVT requires combined antyarrhythmic pharmacotherapy for about 8 months. 3. Premature extrasystole is benign type of arrhythmia in neonates and tends to resolve without treatment.

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