Infant with SVT: A Case Report (original) (raw)
Related papers
University Heart Journal, 2012
SVT or paroxysmal atrial tachycardia or paroxysmal SVT is the most common abnormal tachycardia in children with an incidence of 1:250 to 1:1000. 1 In 90% cases it is due to reentrant tachycardia in otherwise a normal healthy child. Here the rate is usually more than 220 beats per minute and affecting both upper and lower chamber of the heart. 3 The child is usually seen fussy and sleepy than normal. Sometimes SVT can be detected while the baby is still in the mothers womb. 4 In that case, mother will take the pin for her baby. SVT is not a life threatening condition. Treatment is only considered if episodes are prolonged or frequent. For many infants SVT is a time limited problem. So treatment with medication could otherwise be stopped after six to 12 months. 5
Neonatal Supraventricular Tachycardia (SVT)
NeoReviews, 2005
A male neonate born at 31 weeks' gestation had a history of fetal supraventricular tachycardia (SVT) detected at 28 weeks' gestation, with no hydropic changes noticed on ultrasonography. The mother was started on enteral digoxin with instructions for weekly follow-up. On her first return visit at 31 weeks' gestation, ultrasonography revealed hydropic changes and persistent SVT. An emergency cesarean section was performed, and the infant was found to have hydrops and respiratory distress, with a heart rate of 270 beats/min. The patient was intubated and mechanically ventilated and received a dose of intravenous (IV) adenosine, resulting in a transient decrease in heart rate to 120 beats/min before increasing back to 260 to 270 beats/ min. SVT persisted despite institution of an esmolol drip at 500 mcg/kg per minute, and cardioversion was performed when hemodynamic instability developed. Recurrent SVT, associated with hypotension, developed within 45 minutes of successful cardioversion. The patient was given a loading dose of amiodarone, followed by cardioversion, continuous amiodarone, and dobutamine infusion. Echocardiography revealed normal anatomy with moderately reduced function. The patient remained in sinus rhythm and was weaned to oral amiodarone after 1 week of infusion. An echocardiogram revealed normal function. The patient was discharged from the hospital receiving 3 mg/kg per day of oral amiodarone.
Acute Management of Refractory and Unstable Pediatric Supraventricular Tachycardia
The Journal of Pediatrics, 2017
Objective To characterize the management of acute pediatric supraventricular tachycardia (SVT), placing special emphasis on infants, patients refractory to adenosine (refractory SVT), and patients with hypotension, poor perfusion, or altered mental status (unstable SVT). Study design Retrospective cohort study of patients 0-18 years of age without congenital heart disease who presented to our pediatric hospital from January 2003 to December 2012 for the treatment of acute SVT. Multiple logistic regression was applied to identify whether age was a risk factor for different SVT therapies. Model fit and residuals also were examined. Results We identified 179 episodes for SVT. First dose of adenosine was effective in 72 (56%) episodes, and a second dose was effective in 27 of 54 (50%) episodes, leaving 27 (15%) episodes with refractory SVT. The response to the first dose of adenosine increased proportionally with age (OR 1.13, 95% CI 1.05-1.2). Only 1 of 17 episodes in infants responded to the first dose of adenosine. Refractory SVT was more frequent in infants vs older children (c 2 = 5.9 [1 df], P = .01). Unstable SVT was present in 13 episodes and was treated with adenosine and antiarrhythmics. Synchronized cardioversion was performed on 3 patients, 2 patients with unstable SVT, and 1 with refractory SVT.
Predictors of Refractory Tachycardia in Infants with Supraventricular Tachycardia
Reentrant supraventricular tachycardia (SVT) is the most common arrhythmia in infants. There are few predictors as to which patients will have recurrent or refractory SVT. We retrospectively reviewed records of all infants with SVT evaluated at The Hospital for Sick Children, Toronto, between January 1, 1995, and December 31, 1999. Patients with reentrant SVT documented in infancy and structurally normal hearts were included. Patients were placed in two groups: thè`simple'' group consisted of patients with SVT completely controlled by not more than one medication, and thè`complex'' group consisted of patients with recurrent episodes requiring at least one medication change for control. Forty-two cases were analyzedÐ23 in the simple group and 19 in the complex group. One patient in each group died. Age at presentation was 50.4 13.2 days for the simple group versus 10.2 2.5 days for the complex group (p < 0.01). Complex patients were treated with a median of three medications and were more likely to have echocardiographically reduced ventricular function. The surface electrocardiogram RP interval during SVT was signi®cantly longer in complex patients (p < 0.001). There were no dier-ences between the groups in gender, cycle length in SVT or sinus rhythm, the presence of pre-excitation, initial medication choice, or duration of therapy. Recurrent SVT in infancy is associated with younger age and/or ventricular dysfunction at presentation and also with slower ventriculoatrial conduction. The similar duration of therapy for simple and complex patients suggests that the early clinical course of SVT in infancy is not predictive of long-term outcome.
Diagnosis and treatment of supraventricular tachycardias in infants and children
Cardiologia (Rome, Italy), 1990
Supraventricular tachyarrhythmia (SVT) is the most common tachyarrhythmia in pediatric patients and accounts for more than 90% of pediatric arrhythmias. As many as 16 different mechanisms of pediatric SVT exist; we focused in this review article on the three most common groups of SVT mechanisms in pediatrics: atrioventricular re-entry tachyarrhythmia (AVRT), atrioventricular nodal reentry tachyarrhythmia (AVNRT), and atrial tachyarrhythmia (AT). Many methods have been implicated in the diagnosis of SVT like full history taking regarding onset and frequency of palpitation, syncope, chest pain, dyspnea, heart failure, drug intake and physical examination. Children with suspected SVT must be subjected to resting 12-lead surface ECG and ECG during the attack. Echocardiography must be done for detection of any structural heart diseases. Moreover, recent techniques like Electrophysiologic study (EPS) is the most defi nitive diagnostic procedure. Many therapeutic strategies like drugs and radiofrequency ablation (RFA) have been succeeded to provide a signifi cant reduction of the risk of SVT, but RFA offers the prospect of cure of the arrhythmia and avoidance of drug-associated side effects. It is often becoming the fi rst line of therapy for many children with SVT, as it has a relatively low morbidity and mortality, and it results in a low rate of recurrence of SVT.
Sri Lanka Journal of Child Health, 2018
Background: Supraventricular tachycardia (SVT) is the commonest arrhythmias in children. Prompt and appropriate treatment with adenosine and other medicines can be lifesaving. Objectives: To determine the prevalence, management and outcome of children with SVT in an emergency room in a tertiary centre in Nigeria. Method: This prospective, cross sectional and descriptive study was conducted between June 2013 and May 2017 among children from birth to 17 years of age who had SVT. Clinical information was obtained with the aid of a proforma. Electrocardiogram and echocardiogram were performed. The subjects were managed with vagal manoeuvre and administration of available medicines including adenosine, beta blockers and digoxin. Their responses to the treatment offered and outcomes were noted. Data was entered into and analysed with IBM-SPSS version 20.0. Results: Twenty nine (0.4%) of 7693 children seen during the study period had SVT. The median age was 4 months and 12 (41.4%) were males. Seven (24.1%) were unconscious and 14 (48.3%) were either in heart failure or shock at presentation. Only four (13.8%) had adenosine while 17 (58.6%) received both beta blockers and digoxin of whom 50% responded. Eleven (37.9%) children died. Conclusions: In this study the prevalence of SVT was 0.4%. Whilst 08 (27.6%) children with SVT were treated only with vagal manoeuvres, 04 (13.8%) were treated with adenosine, 09 (31.0%) with metoprolol and 08 (27.6%) with digoxin. Mortality was 38%.
Supraventricular Tachycardia in Infants: Epidemiology and Clinical Management
Current Pharmaceutical Design, 2008
Supraventricular tachycardias (SVTs) are observed in 0,1-0,4% of the paediatric population and represent an important clinical problem with related significant health and social issues. Most tachycardias are paroxysmal, being associated with sudden onset and termination, and only a relatively small number of them is permanent, namely chronic. Paroxysmal tachycardias, in addition, can be either sustained (lasting > 30 seconds) or non-sustained whenever their duration is less. Most SVTs are due to re-entry, and only atrial tachycardia and and junctional ectopic tachycardia are caused by enhanced automaticity. Atrial tachycardia, however, can also be due, although rarely, to re-entry or to triggered activity. A prompt recognition of these arrthmias in children by pediatric cardiologist is essential for a correct clinical managemet of the patients. In this review, the epidemiologic data regarding the SVTs in pediatric age are reported along with the description of the pathophysiological mechanisms and the analysis of electrocardiographic findings to be considered for a correct clinical diagnosis and a rational therapeutic approach to these arrhythmias.
Pediatric Cardiology, 2011
Supraventricular tachycardia (SVT) presenting in the neonatal period may resolve by 1 year of age. Predicting which patients require therapy beyond 1 year of age is desirable. Pediatric electrophysiology databases from two institutions were reviewed for patients with a history of infant SVT who underwent transesophageal electrophysiology study (TEEPS) after initial SVT and before 2 years of age. All patients were tested off medications and followed for clinical recurrence. Forty-two patients presented with SVT at median age of 4 days (0-300 days). Initial control was achieved with one drug in 31 patients and multiple drugs in 11 patients. Prior to TEEPS, nine patients had clinical recurrence in the first year of life after initial control had been previously achieved. For all patients, TEEPS was performed, without complications, at median 13 months (9-22 months) of age and at median of 13 months (6-22 months) following the initial SVT episode. SVT was inducible in 27/42: 8 atrio-ventricular nodal reentry tachycardia (AVNRT) and 19 atrio-ventricular reciprocating tachycardia (AVRT). Inducibility was not associated with age at presentation, age at TEEPS, ventricular dysfunction at presentation, presence of structural congenital heart disease, number of drugs required to initially control SVT, or SVT recurrence after initial control. Of 15 not inducible at TEEPS, none had known SVT recurrence off medications at median follow-up of 27 months (6-37 months). In conclusion, among patients having SVT in early infancy,