Refractory supraventricular tachycardia in the neonate: treatment with temporary antitachycardial pacing

Although intracardiac antitachycardial pacing techniques are frequently used to terminate reentrant supraventricular tachycardia in adults, this approach has rarely been used in neonates. We describe two neonates, both of whom were in circulatory shock due to recurrent paroxysmal supraventricular tachycardia, who were treated with temporary antiatachycardial pacing. This approach allows repeated termination of the tachycardia at the bedside until an adequate therapeutic concentration of an effective drug regimen is achieved and obviates repeated direct-current cardioversion.