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[Extrasystole in the neonatal period]
Insights
Premature beats are common in newborns, with ventricular types more frequent. While often resolving within a month, persistent cases require monitoring, and immaturity may be a cause.
Area of Science:
- Neonatal cardiology
- Pediatric electrophysiology
Context:
- Premature beats, or extra heartbeats, are frequently observed in healthy newborns.
- Continuous monitoring reveals a prevalence of 7-25% for these arrhythmias.
Purpose:
- To investigate the clinical course, frequency, pathogenesis, and therapy of premature beats in 35 healthy newborns.
- To compare findings with existing literature on neonatal arrhythmias.
Summary:
- Ventricular premature beats were found in half of the studied newborns, a higher proportion than reported in literature.
- These arrhythmias can be complex, sometimes associated with atrial flutter, and typically resolve within the first month, though some persist longer.
- Therapy is reserved for cases with heart failure or significant tachycardia; immaturity of nervous and cardiac conduction systems is a potential cause.
Impact:
- Provides insights into the natural history and management of neonatal premature beats.
- Highlights the high incidence of ventricular premature beats in this population.
- Suggests immaturity as a contributing factor to perinatal arrhythmias.
Abstract:
We investigated the clinical course in 35 healthy newborn with premature beats and studied the literature with regard to their frequency, pathogenesis, and therapy with the following results: Investigations with continuous monitoring or long-term ECG registration show a frequency of 7-25%. In literature, almost one-fourth, in our patients one-half of the newborn have ventricular premature beats. These will probably disappear later than atrial premature beats, but their prognosis is not worse. The premature beats of newborn are often complex (blocked or aberrant conduction, bigeminus, tachycardia). Atrial flutter is sometimes associated. In one-half of cases they disappear spontaneously during the first month of life. However, they lasted for longer than 4 months in 7 out of 35 infants. The disorder increased after birth in 2 children, which is unusual. Therapy was indicated if there were signs of heart failure, frequent or increasing rate of tachycardia or atrial flutter. Premature beats do not indicate primary operative delivery. Immaturity of the central and autonomous nervous system and of the conduction-tissue of the heart may be the reason for frequent perinatal premature beats.