Supraventricular tachycardia (SVT) is the most challenging arrhythmia in newborn, requiring urgent medical attention...
Adenosine, when administered in the correct dose with the correct means is very effective with success rates of 85% to 100% . Adenosine appears to be the most promising antiarrhythmic agent. Adenosine can be given in a starting dose of 0.1 mg/kg, increasing by 0.1mg/kg increment at 2 minutes interval till sinus rhythm is restored.
Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias.
The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child.
In approaching cardiac emergencies, cardiac disease can be divided into
structural disease, conduction abnormalities, and acquired illnesses. While
recognizing that many lesions can be a combination of many defects, structural congenital heart disease can be divided into cyanotic and acyanotic
You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. And if you’re like me, you don’t feel quite as confident managing sick infants with critical heart disease as you do managing sepsis.
Supraventricular tachycardia may lead to cardiac failure
and cardiovascular collapse; and it is an important cause
of morbidity and mortality in newborns. Adenosine is the
first-line treatment with high efficacy and safety.
Several types of arrhythmias are seen in the neonate; most of them are benign. However, supraventricular tachycardia (SVT), the most common rhythm disorder in this age group, may cause significant hemodynamic disturbance
Most episodes of neonatal supraventricular tachycardia (SVT) only last for a few minutes and do not need urgent treatment. Some babies are affected by episodes that last longer so you may be given regular medication to reduce or stop the chance of prolonged periods of SVT. This is often a beta blocker medicine to keep the child’s heart rate regular. Other medicines such as flecanide, digoxin and amiodarone can also be used.
Children Have Hearts... Things can go wrong with them.
With major advances in the field of pediatric cardiology over the past few decades,
outlook for children with congenital heart disease has improved immensely. Congenital heart
defects, which were once considered incompatible with life, are now regularly managed
immediately after birth with good survival. Better understanding of basic cardiovascular
physiology behind such emergencies, has led to more focused and etiology oriented management
resulting in better outcome.
Most common are; Sinus Tach -50%, SVT - 13%...
the outcomes are typically poor. Less than 10% of pediatric patients survive cardiac arrest, and only about a third of those who do survive will have a good neurologic outcome.
Amiodarone was the most commonly used acute therapy in our cohort. Amiodarone therapy for acute management of recurrent adenosine-refractory SVT in children has been reported previously, including one retrospective study comparing its safety and efficacy to procainamide
Supraventricular tachycardia (SVT) is the most challenging
arrhythmia in newborn, requiring urgent medical attention.
The incidence of SVT is estimated to be 1 in 200 to 250 for
neonates. There are several pharmacologic
antiarrhythmic options but the mainstay of medical therapy of
acute SVT is intravenous adenosine.