Neonatal supraventricular tachycardia: outcomes over a 27-year period at a single institution.

AIM: To establish prognosis in neonatal supraventricular tachycardia.

METHODS

All 109 patients <30 days with supraventricular tachycardia due to accessory atrioventricular or atrioventricular nodal reentry from 1971 to 1997 at one institution were retrospectively reviewed.

RESULTS

There were seven deaths (6%): five cardiac failure, two not related to arrhythmia. Freedom from arrhythmia, antiarrhythmic medication or late recurrence of arrhythmia was 52% at 1 year, 82% at 5 years and 83% at 10 years. At 10 years 31% of patients with ventricular preexcitation on electrocardiogram had symptoms or medication compared to 6% in those with concealed pathways (p < 0.0001). In patients who needed multiple drugs or more than 6 days to obtain initial arrhythmia control, 50% had arrhythmias at 10 years, compared to 10% of more easily treated cases (p = 0.001).

CONCLUSION

Ventricular preexcitation and initial treatment difficulties, but not foetal presentation, were significant risk factors for prolonged arrhythmia, as confirmed by multivariate analysis. In the remainder, arrhythmia resolved in approximately 90%.