Arrhythmias in Neonates and Infants at a Tertiary Care Center

Abstract

Background Limited data about arrhythmias in neonates and infants are coming out from the Middle East. Objectives To evaluate different types of arrhythmias in neonates and infants at the American University of Beirut Medical Center (AUBMC), a tertiary care center in Lebanon, with the focus on the nature of arrhythmia, treatment modalities and relation to surgery. Methods Data were collected retrospectively from the hospital records. We included all neonates and infants presenting to AUBMC between 2013 and 2017. Collected data included: the type of arrhythmia, the treatment modality used and its success, the need for additional modes of treatment, the relationship to congenital heart diseases, and the cardiac surgeries performed. Results Of 16,346 subjects admitted to AUBMC between 2013 and 2017, 90 subjects developed arrhythmias that required medical intervention. The most frequent types of arrhythmias were supraventricular tachycardia (62.22%), junctional ectopic tachycardia (13.33%), complete heart block (7.78%), atrial flutter (5.56%), multifocal atrial tachycardia (3.33%), Wolf Parkinson White Syndrome (3.33%), non-sustained ventricular tachycardia (2.22%), sinus pause (1.11%), and premature ventricular contractions (1.11%). Bivariate analysis showed a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in terms of the type of arrhythmia developed, the presence of congenital heart defect, prematurity, and electrolyte disturbances (P-value <0.005). However, multivariate logistic regression showed no significant difference between the two groups after adjustment for the significant variables (P-value > 0.05). Conclusion There is a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in neonates and infants at AUBMC. However, the difference disappears after adjusting for different variables.

Clinical Characteristics of Cardiac Arrhythmias in Pediatric Age Group

“…As in our investigation, Marwan Refaat et al [12] conducted a study of arrhythmia in neonates and babies in a tertiary care institution in Lebanon. They found that 91.1% of the study patients had different forms of tachyarrhythmias and only 8.89% out of their patients had Bradyarrhythmias.…”

“…In the current study AV block was the more common pediatric bradycardia (47 patients with AV nodal disease Vs 8 patients with sinus node disease). Also, Marwan Refaat et al [12] found AV blocks to be a more common bradycardia than sinus node dysfunction.…”

Management of post-operative Junctional Ectopic Tachycardia in symptomatic neonates and infants at a tertiary care center in a developing country: Lessons learned!

“…6,7 Since data related to JET occurring in neonates and infants are scarce from the Middle East, we analyzed all recorded cases of JET in this age category at a tertiary care center in Lebanon hospitalized between January 1, 2013, and December 31, 2017, as a part of a study on arrhythmias in neonates and infants done over the same time frame. 8,9 We aim to highlight the epidemiology, incidence, and management of this rare form of arrhythmia in this age group.…”