Preterm infants with paroxysmal supraventricular tachycardia: presentation, response to therapy, and outcome.
OBJECTIVE
We investigated the clinical course of preterm infants with paroxysmal supraventricular tachycardia in comparison to their term counterparts.


BACKGROUND
Paroxysmal supraventricular tachycardia (PSVT) is the most common arrhythmia in childhood. It is known to cause significant morbidity and rarely mortality, most commonly in infants. Yet, there is minimal information in the literature on preterm infants with PSVT.


METHODS
Retrospective review of 40 infants, 26 term and 14 preterm, less than three months of age who presented with PSVT from January 1990 to January 1999. We compared the severity of first clinical presentation, in-hospital response to long-term medications, and outcome after discharge.


RESULTS
Symptomatic severity on presentation was not different between preterm and term infants. Preterm infants required fewer medication trials (p=0.01) and had no recurrences after discharge in contrast with 43 % recurrence in the term infants (p<0.0001). No preterm infants had Wolff-Parkinson-White syndrome (WPW) in contrast to 42 % of term infants (p=0.003). Term infants with WPW were more symptomatic (p=0.01), required more medications (p=0.004), but had a similar recurrence frequency as terms infants without WPW (p=0.95). Excluding infants with WPW, preterm infants were more severely symptomatic (p=0.02), yet no longer was there a difference in response to first medication trial (p=0.30).


CONCLUSIONS
We found that preterm infants with PSVT are as severely symptomatic on presentation, require fewer medications for adequate in-hospital control, and have fewer recurrences than their term counterparts. Unexpectedly, preterm infants did not present with WPW. The presence of WPW only in the term infants may account for differences in the clinical course between preterm and term infants.
Goldman
L E
LE
Department of Pediatrics, Yale University School of Medicine, USA.
Boramanand
N K
NK
Acevedo
V
V
Gallagher
P
P
Nehgme
R
R
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008134:Long-Term Care; D008297:Male; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D015996:Survival Rate; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality
D000889:Anti-Arrhythmia Agents