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

To establish prognosis in neonatal supraventricular tachycardia.

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.

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).

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%.