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Perinatal arrhythmias

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Abstract

Cardiac arrhythmias are very frequent in fetuses and newborns. The prognosis depends on the nature of the arrhythmias but is most often either spontaneously benign or following short-term medication administration. A correct diagnosis is essential for both management and prognosis. It is based on echocardiography during the fetal period and mainly on history, physical exam, and electrocardiogram after birth, but other modalities are available to record transient arrhythmic events. Irregular rhythms are mostly benign and rarely require therapy. In most fetuses and infants, tachyarrhythmias resolve spontaneously or require short-term administration of antiarrhythmics. Approximately one third of these may recur later on, especially during adolescence. Persistent bradyarrhythmias might require pacemaker implantation when associated with failure to thrive or with risk of sudden death. Conclusion: Arrhythmias in fetuses and infants are very common and mostly benign. History, physical exam, and recording of the arrhythmia are essential to make a correct diagnosis and establish an appropriate management for the rare potentially harmful arrhythmias.

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Abbreviations

ABC:

Airway, breathing, circulation

AET:

Atrial ectopic tachycardia

APB:

Atrial premature beat

AV:

Atrioventricular

AVB:

Atrioventricular block

AVNRT:

Atrioventricular nodal reentrant tachycardia

AVRT:

Atrioventricular reentrant tachycardia

CHD:

Congenital heart disease

ECG:

Electrocardiogram

JPB:

Junctional premature beat

JET:

Junctional ectopic tachycardia

PALS:

Pediatric advanced life support

PJRT:

Permanent junctional reciprocating tachycardia

SVT:

Supraventricular tachycardia

VPB:

Ventricular premature beat

VT:

Ventricular tachycardia

WPW:

Wolff-Parkinson-White syndrome

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Acknowledgments

Some Doppler recording tracings were provided courtesy of Jean-Claude Fouron MD, Pediatric Cardiology, Sainte Justine Hospital, Montreal, Canada.

Conflict of interest

The authors do not have any conflict of interest regarding this publication.

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Authors and Affiliations

  1. Cardiology Division, Pediatrics Department, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Route du Bugnon 46, Bureau BH11/632, 1011, Lausanne, Switzerland

    Nicole Sekarski, Erik Jan Meijboom, Stefano Di Bernardo, Tatiana Boulos Ksontini & Yvan Mivelaz

  2. Current affiliation: Pediatric Cardiology, University of Twente, Enschede, Netherlands

    Erik Jan Meijboom

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  1. Nicole Sekarski
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  2. Erik Jan Meijboom
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Correspondence to Yvan Mivelaz.

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Communicated by Patrick Van Reempts

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Sekarski, N., Meijboom, E.J., Di Bernardo, S. et al. Perinatal arrhythmias. Eur J Pediatr 173, 983–996 (2014). https://doi.org/10.1007/s00431-014-2316-4

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