Introduction: Neonatal dysrrhythmias - including supraventricular tachycardia (SVT), as well as severe bradycardialinked to total congenital atrio-ventricular block (AVB), may be life threatening,
Arrhythymias in fetus may occur on a structural normal heart or in association with heart defects. These are now more often detected as the fetal echocardiography is increasingly available in our country, and offer better chances of treatment and survivals. Neonatal arrhythmias are considered those occurring in the first 30 days of life.
Aim of the study: we have done a retrospective study on fetal and neonatal detected arrhythmias between the years 2007 -2013, concerning diagnosis and treatment.
Method and material: There were 7 cases of supraventricular tachycardia ( male : female ratio = 5:2), and 4 cases of total AV block ( male:female ratio= 1:3). Among these a number of 3 cases of supraventricular tachycardia and 2 congenital AV block were detected prenatal. All cases of supraventricular tachycardia occured on structural normal heart, but 2 of the AV blocks associated a double outlet right ventricle with inverted ventricles, and a pulmonary stenosis.
Results: A VVI pacemaker was implanted in 3 cases of AVB between 3 and 8 weeks of life, because of heart failure signs. In one case of fetal SVT and hydrops (24 weeks gestational age), the mother was treated with sotalol, and the fetus could be born on term, healthy. The other were treated with betablockers, propafenone, sotalol, digoxine, with good response to therapy. Heart failure signs occurred in 3 cases. The antiarrhytmic treatment was maintained for 1 year. No long term relapsoccured. There was no death.
Conclusion: Supraventricular tachycardia is severe if in association with heart failure or hydrops. The duration of tachycardia is important in launching the heart failure signs, therefore an early diagnosis and imediat start of the treatment is essential. Total AV block is more severe if a heart defect is associated, and pacemaker implantation is necessary if heart failure occurs.