Studija slučaja
https://doi.org/10.21857/mjrl3uopj9
Neonatal supraventricular tachycardia (SVT) – report of 2 cases
Vinko Vrdoljak
; Division of Neonatology, Department of Obstetrics and Gynecology, „Sestre Milosrdnice“ University Hospital Center, Zagreb, Croatia
*
Lorita Mihovilović Prajz
; Division of Neonatology, Department of Obstetrics and Gynecology, „Sestre Milosrdnice“ University Hospital Center, Zagreb, Croatia
Edi Paleka Bosak
; Division of Neonatology, Department of Obstetrics and Gynecology, „Sestre Milosrdnice“ University Hospital Center, Zagreb, Croatia
Stella Radina Jurčić
; Division of Neonatology, Department of Obstetrics and Gynecology, „Sestre Milosrdnice“ University Hospital Center, Zagreb, Croatia
Katarina Bojanić
; Division of Neonatology, Department of Obstetrics and Gynecology, „Sestre Milosrdnice“ University Hospital Center, Zagreb, Croatia
Nikola Krmek
; Department of Pediatrics, Division of Cardiology, Nephrology and Rheumatology with Immunology, “ Sestre Milosrdnice“ University Hospital Center, Zagreb, Croatia
* Dopisni autor.
Sažetak
Neonatal supraventricular tachycardia (SVT) is a significant medical emergency characterized by an abnormally rapid heart rhythm originating above the ventricles. It commonly manifests as atrioventricular reentrant tachycardia (AVRT) and presents diagnostic and therapeutic challenges in neonatology. Early recognition and appropriate management are critical to improving outcomes.
Case Reports
This paper details two cases of neonatal SVT. The first case involves a female neonate diagnosed with persistent fetal tachycardia at 31 weeks of gestation. Despite comprehensive maternal antiarrhythmic therapy, including sotalol, bisoprolol, digoxin, and flecainide, the tachycardia persisted, necessitating delivery at 37 weeks and subsequent neonatal interventions. The neonate required a combination of antiarrhythmic drugs, including propranolol, propafenone, and amiodarone, to achieve and maintain sinus rhythm. The clinical course was further complicated by early neonatal sepsis and human herpesvirus 6 (HHV-6) infection.
The second case describes a male neonate born with a history of suspected fetal tachyarrhythmia and congenital anomalies, including Wolff-Parkinson-White (WPW) syndrome and hereditary spherocytosis. Postnatal episodes of SVT were managed with adenosine and a regimen of antiarrhythmics, including propranolol, metoprolol, and sotalol. Despite recurrent SVT episodes and anemia requiring transfusions, the neonate achieved sustained remission of SVT before discharge.
Discussion
Management of neonatal SVT emphasizes stabilization, acute episode termination, and prevention of recurrence. Vagal maneuvers, adenosine, and synchronized cardioversion are first-line acute therapies. Long-term management often requires multiple antiarrhythmic medications tailored to the individual neonate. Spontaneous resolution of SVT is anticipated in most cases within the first year of life, reducing the long-term reliance on pharmacological therapy.
Conclusion
These cases highlight the complexity of neonatal SVT management, including the interplay of maternal and neonatal interventions, the risks of antiarrhythmic therapies, and the need for multidisciplinary collaboration. Early diagnosis and tailored treatment strategies are essential to improving neonatal outcomes, particularly in the presence of comorbid conditions like WPW syndrome and sepsis. Further research is needed to refine therapeutic protocols and optimize outcomes for this vulnerable population.
Ključne riječi
Supraventricular Tachycardia; Neonatology; Arrhythmias, Cardiac; Anti-Arrhythmia Agents; Wolff-Parkinson-White Syndrome
Hrčak ID:
326031
URI
Datum izdavanja:
20.12.2024.
Posjeta: 0 *