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Extrasystoles on 24-h Holter Monitoring During the First Year of Life
Asta Uusitalo1,2, Päivi H Korhonen1,2, Antti Tikkakoski3
1Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
Insights
Most newborn extrasystoles, including atrial premature contractions (APCs) and ventricular premature contractions (VPCs), resolve within the first year. Frequent extrasystoles in infants may indicate a risk for tachyarrhythmias, warranting monitoring.
Area of Science:
- Pediatric Cardiology
- Neonatal Electrophysiology
- Cardiac Arrhythmias
Background:
- Extrasystoles are common in newborns.
- Their natural course and association with other arrhythmias require further investigation.
Purpose of the Study:
- To evaluate the natural progression of extrasystoles in infants.
- To determine the link between extrasystoles and tachyarrhythmias using 24-hour Holter monitoring.
Main Methods:
- Retrospective analysis of 290 Holter recordings from 75 newborns (2011-2017).
- Inclusion criteria: >1% extrasystoles on initial Holter monitoring.
- Follow-up assessment of extrasystole resolution and occurrence of tachyarrhythmias.
Main Results:
- Extrasystole prevalence peaked within 14 days, decreasing significantly by 2 months.
- 92% of atrial premature contractions (APCs) and 78% of ventricular premature contractions (VPCs) resolved within a year.
- Tachyarrhythmias were detected in 23% of cases; higher extrasystole percentage correlated with tachyarrhythmias.
Conclusions:
- Newborn extrasystoles generally have a favorable prognosis.
- Serial Holter monitoring is recommended for infants with frequent extrasystoles due to potential tachyarrhythmia risk.
Aim:
To assess the natural course of extrasystoles and their association with tachyarrhythmias on 24-h Holter monitoring during the first year of life.
Methods:
A retrospective chart review was performed among newborns referred for 24-h Holter monitoring at Tampere University Hospital from 2011 to 2017. Children with more than 1% extrasystoles on the initial Holter recording were included.
Results:
In total, 75 children and 290 Holter recordings were included. Forty-seven (63%) children were followed up due to atrial premature contractions (APCs) and 28 (37%) children were followed up due to ventricular premature contractions (VPCs). The amount of extrasystoles peaked during the first 14 days and decreased significantly during the first 2 months. However, in one-third of the children, extrasystoles increased between recordings. Extrasystoles disappeared during the first year among 92% of children with APCs and 78% of children with VPCs. Short supraventricular or ventricular tachycardias were found in 17 (23%) children's recordings. A higher percentage of extrasystoles was associated with tachyarrhythmias.
Conclusion:
The results support the prevailing understanding regarding the favourable prognosis of extrasystoles in newborns. Serial Holter monitoring may be advisable during the newborn period for infants with frequent extrasystoles, as some may be susceptible to tachyarrhythmias.
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