Neonatal cardiac arrhythmia: a retrospective analysis of 128 cases / 中国新生儿科杂志

ABSTRACT

Objective To discuss the clinical features,pathogenesis,diagnosis,treatment and therapeutic outcome of neonatal cardiac arrhythmia.Method The clinical data of newborns with arrhythmia admitted from May 2013 to May 2018 were analyzed retrospectively.All cases were grouped into benign and non-benign arrhythmia groups according to the severity of clinical manifestations.The clinical features,pathogenesis,diagnosis,treatment and therapeutic outcome of them were compared.Result There were 128 cases including 89 (69.5％) males,39 (30.5％) females;106 (82.8％) full-term infants,22 (17.2％) premature infants;39 (30.5％) atrial premature contraction,5 (3.9％) atrial tachycardia,10 (7.8％) atrial flutter,36 (28.1％) paroxysmal supraventricular tachycardia,26 (20.3％) ventricular premature contraction,12(9.4％) atrioventricular block;65 cases (50.8％) were benign arrhythmia and 63 cases (49.2％) were non-benign.52 cases (40.6％) showed noncardiac symptoms (including 10 cases of shortness of breath,9 cases of pallor or cyanosis,5 cases of refusal to suck,3 cases of grunting,25 cases with two or more than two kinds of clinical symptoms),and 76 cases (59.4％) were asymptomatic;31 cases (24.2％) were cardiac insufficiency.The three common causes of neonatal cardiac arrhythmia were32 (25％) cases by infection,20 (15.6％) cases by perinatal asphyxia,19 (14.8％) cases were congenital heart disease;87 (68.0％) cases were mainly treated with primary diseases.41 cases (32.0％) were treated with antiarrhythmic drugs or cardioversion.There was significant difference in gender,noncardiac symptoms,cardiac insufficiency,age of onset,days of hospitalization,cardiac troponin Ⅰ and creatine kinase isoenzyme between the two groups (P ＜ 0.05).Conclusion Neonatal cardiac arrhythmias should be considered and evaluated with shortness of breath,cyanosis or pallor and rejection refusal of milk.High risk factors of neonatal cardiac arrhythmias included infection,perinatal asphyxia and congenital heart disease.Benign and non-benign arrhythmia should be identified.