Management of Neonatal Supraventricular Tachycardias; A Single Center Experience

Abstract

Objectives: Emergent treatment of neonatal supraventricular tachycardia (SVT) is very crucial because it may lead tolife threating conditions. The aim of this study is to evaluate the neonatal SVTs.Methods: Neonates, who were diagnosed with SVT between December 2014 and May 2018, were analyzed. Clinicalfindings, electrocardiogram (ECG) and echocardiography findings, 24-hour Holter ECG recordings and medicationswere evaluated.Results: 46 over 1932 newborns were diagnosed with SVT. 76% of patients were common SVT with narrow QRS andshort RP, 13% with Wolff-Parkinson-White syndrome, 4.3% with multifocal atrial tachycardia, 4.3% with atrial flutter,2.1% with permanent reciprocating junctional tachycardia. Adenosine terminated SVT in 84.4% of the cases. Synchronizedcardioversion was performed in 10.8% cases. Amiodarone and/or esmolol for acute treatment was used in 39.1%.Propranolol, digoxin, amiodarone, propafenone and flecainide were the drugs used for monotherapy or combinationtherapies.Conclusion: In patients with initially unresponsive to standard dose of adenosine and under acute treatment withamiodarone and/or emolol continuous infusion, higher doses of adenosine (300-500 μg/gr/kg) is very effective.Amiodarone alone and in combination with flecainide seems safe and effective.