2015, Number 4
<< Back Next >>
CorSalud 2015; 7 (4)
Supraventricular tachycardia in a newborn: A diagnostic and therapeutic challenge in medical practice
Chávez GE, Ramos RRR
Language: Spanish
References: 15
Page: 309-313
PDF size: 523.48 Kb.
ABSTRACT
Supraventricular tachycardias in children are the fastest rhythms most frequently reported
(70%). Orthodromic tachycardia is that which usually occurs in newborns, and
its treatment with amiodarone together with beta blockers has an effectiveness of
63%. However, the combination of antiarrhythmic drugs in children and infants is not
recommended because of the proarrhythmic effects. Electrophysiological study and
radiofrequency ablation are reserved for older children, where there is less risk of
procedures; besides little risk has been reported in children with accessory pathways.
The case of an 11-day-old newborn who presented two electrocardiographically different
episodes of tachycardia is reported. Those episodes suggested unequal production
mechanisms of the arrhythmia, which was difficult to control and needed the
combination of three antiarrhythmic drugs for maintaining sinus rhythm.
REFERENCES
Blanca Jover E, Jerez Calero A, Contreras Chova F, Molina Oya M, Garrido Torrecillas FJ, Cutillas Abe-llán N. Principales arritmias en Pediatría. Recono-cimiento por parte del Pediatra de Atención Prima-ria y actuación interniveles. Bol SPAO. 2010;4:44-54.
Pérez Lescure FJ, Echávarri Olavarría F. El electro-cardiograma en Pediatría de Atención Primaria (II). Cambios relacionados con la edad y arritmias básicas. Rev Pediatr Aten Primaria. 2005;7:463-80.
Schwartz PJ, Garson A, Paul T, Stramba-Badiale M, Vetter VL, Wren C, et al. Guidelines for the inter-pretation of the neonatal electrocardiogram. A task force of the European Society of Cardiology. Eur Heart J. 2002;23:1329-44.
Trivedi B, Kanter R. Arrhythmias in Children. En: Yan GX, Kowey PR, eds. Management of Cardiac Arrhythmias. New York: Springer; 2011. p. 355-92.
Sippensgroenewegen A, Mlynash MD, Roithinger FX, Goseki Y, Lesh MD. Electrocardiographic analy-sis of ectopic atrial activity obscured by ventricular repolarization: P wave isolation using an automatic 62-lead QRST subtraction algorithm. J Cardiovasc Electrophysiol. 2001;12:780-90.
Barnes S, Shields B, Boney W, Hardin J, Abdulla R. The Pediatric Cardiology Pharmacopoeia: 2004 Up-date. Pediatr Cardiol. 2004;25:623-46.
Chernovetzky GM. Guía para la atención del recién nacido con arritmias. Rev Hosp Mat Inf Ramón Sardá. 2001;20:168-80.
Grueso J. Tratamiento farmacológico de las arrit-mias en niños. An Pediatr Contin. 2007;5:283-8.
Gaztañaga L, Marchlinski FE, Betensky BP. Meca-nismos de las arritmias cardiacas. Rev Esp Cardiol. 2012;65:174-85.
10.Valderrabano M. Influence of anisotropic conduc-tion properties in the propagation of the cardiac action potential. Prog Biophys Mol Biol. 2007;94: 144-68.
11.Drago F, Grutter G, Silvetti MS, De Santis A, Di Ciommo V. Atrioventricular nodal reentrant tachy-cardia in children. Pediatr Cardiol. 2006;27:454-9.
12.Stefani AN, Dal Fabbro GR, Bosaleh MJ, Vásquez R, Costa GA, Speranza R, et al. Seguimiento de 134 pacientes pediátricos con patrón de Wolff-Parkin-son-White: evolución natural e intervención médi-ca. Rev Argent Cardiol. 2013;81:415-21.
13.Pappone C, Santinelli V, Manguso F, Augello G, San-tinelli O, Vicedomini G, et al. A randomized study of prophylactic catheter ablation in asymptomatic pa-tients with the Wolff-Parkinson-White syndrome. N Engl J Med. 2003;349:1803-11.
14.Lerman BB, Basson CT. High-risk patients with ven-tricular preexcitation - A pendulum in motion. N Engl J Med. 2003;349:1787-9.
15.Geiter HB. Understanding Wolff-Parkinson-White and preexcitation syndromes. Nursing. 2003;33: 32CC1-4.