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Frequent ectopic beats12/14/2023 ![]() ![]() The accessory pathway connecting impulses between the atrium and the ventricle can be seen at any site in the AV groove. WPW syndrome is defined as a congenital condition involving an abnormal electrical conduction of the accessory pathway. A rare mechanism of tachycardia is triggered activity, which includes atrial fibrillation (AF) 4, 5, 9, 10, 11).ġ) Atrioventricular reentrant tachycardiaĪccessory pathway-related AVRT is commonly associated with Wolff-Parkinson-White (WPW) syndrome in neonates. Another mechanism of tachycardia is increased automaticity, which includes sinus tachycardia, ectopic atrial tachycardia (EAT), and JET. Accessory pathway-related AVRT, AVNRT, and PJRT can be classified as reentry tachycardias. The mechanism of tachycardia is associated with reentry, automaticity enhancement, and triggered activity. ![]() Real SVT includes accessory pathway-related AV reentrant tachycardia (AVRT), AV nodal reentrant tachycardia (AVNRT), permanent form of junctional reciprocating tachycardia (PJRT), and junctional ectopic tachycardia (JET). SVT is classified into 2 types real SVT and atrial tachycardia. SVT is defined as tachycardia resulting from an abnormal mechanism involving the heart structures proximal to the bifurcation of the bundle of His, and that does not have the morphology of atrial flutter (AFL) on the surface ECG. SVT is the most common type of tachyarrhythmia observed in pediatric patients, especially in the neonatal period. In this article, I review the current understanding of the common clinical presentations, etiology, natural history, and management of neonatal arrhythmias in patients without underlying CHD. Previous studies reported that arrhythmic substrates predispose patients to CHD-related arrhythmia, and the clinical manifestations and treatment differ between patients with a normal heart and those with CHD. In addition, surgical correction may also be related to the cause of arrhythmia in patients with CHD. Congenital heart disease (CHD) not only affects the anatomical defect but also causes electrical changes, that induce various arrhythmias. ![]() Supraventricular tachycardia (SVT), ventricular tachycardia (VT), atrioventricular (AV) conduction abnormalities, and genetic arrhythmias such as congenital long-QT syndrome (LQTS) are classified as nonbenign arrhythmias 1, 2, 3, 4, 5). Benign arrhythmias include sinus arrhythmia, premature atrial contraction (PAC), premature ventricular contraction (PVC), and junctional rhythm these arrhythmias have no clinical significance and do not need therapy. Neonatal arrhythmias are classified as either benign or nonbenign. The incidence of neonatal arrhythmia is reported to be 1%–5% in all neonates 1, 2, 3). In this article, I review the current understanding of the common clinical presentation, etiology, natural history, and management of neonatal arrhythmias in the absence of an underlying congenital heart disease.Īrrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Precise diagnosis with risk stratification of patients with nonbenign neonatal arrhythmia is needed to reduce morbidity and mortality. Although most neonatal arrhythmias are asymptomatic and rarely life-threatening, the prognosis depends on the early recognition and proper management of the condition in some serious cases. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm these arrhythmias have no clinical significance and do not need therapy. Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. ![]()
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