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Neonatal catecholaminergic ventricular tachycardia--a case report
1Department of Pediatrics, Yamanashi Medical University, Tamaho, Japan.
Japanese Circulation Journal
|September 25, 1999
Summary
Neonatal catecholaminergic ventricular tachycardia, a rare condition, can be triggered by stress and managed with medication. This case highlights triggered activity as a potential cause in infants.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Neonatal Medicine
Background:
- Neonatal catecholaminergic ventricular tachycardia (N-CVT) is a rare, life-threatening arrhythmia.
- It typically presents in infancy and is often triggered by adrenergic stimuli.
- Diagnosis and management can be challenging due to the critical condition of affected neonates.
Observation:
- A case of fetal tachycardia was detected in a female neonate.
- Postnatal monitoring revealed sustained monomorphic ventricular tachycardia with a left bundle branch block pattern and inferior axis.
- The tachycardia was inducible by crying, sucking, and isoproterenol infusion, suggesting catecholaminergic sensitivity.
Findings:
- No overt congenital heart disease was identified on routine examination.
- Intravenous adenosine triphosphate (ATP) and propranolol effectively suppressed the ventricular tachycardia.
- Oral propranolol provided long-term control of the arrhythmia.
- The mechanism was suspected to be triggered activity.
Implications:
- This case underscores the importance of considering N-CVT in neonates presenting with unexplained ventricular tachycardia.
- Early diagnosis and prompt management with beta-blockers are crucial for favorable outcomes.
- Understanding the role of triggered activity may inform future therapeutic strategies for N-CVT.