Congenital Arrhythmias with Supraventricular Tachycardia in the Perinatal Period

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Abstract
Fourteen cases with perinatal tachyarrhythmia are described. Intra‐uterine cardiac arrhythmia was observed in 8 cases: 6 with paroxysmal supraventricular tachycardia (PST) and 2 with atrial flutter, all but one with variable AV‐block, and heart rate ranging between 120–230 beats/min. Caesarean section was performed because of suspected asphyxia in 4 cases and delivery by vacuum extraction in 2 of the 8 cases. All 6 cases first appearing in the first 4 days of life had PST with a heart rate varying from 210–310. Congestive heart failure, occurring in 10 cases in the total series, developed significantly earlier in the patients with intra‐uterine diagnosed tachycardia. No cause was found in 10 cases, and only 2 cases displayed the Wolff‐Parkinson‐White (WPW) syndrome. The importance of early ECG recording in all neonates with arrhythmia is stressed. An increased use of the fetal ECG is recommended in cases with rapid or irregular fetal heart sounds. The delivery should be accelerated when the fetal heart rate is constantly more than 200 beats/min.

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