Evaluation of the clinical course and therapeutic approaches in neonatal supraventricular tachycardia: a retrospective study

Aim The purpose of this study was to evaluate the clinical course of and therapeutic approaches toward neonatal supraventricular tachycardia (SVT) in the neonatal intensive care unit (NICU). Methods Data on demographic characteristics, clinical course, echocardiographic findings, treatments administered, and treatment responses in neonates diagnosed with SVT in the NICU between January 2007 and January 2023 were evaluated retrospectively. Results Thirty-five neonates with SVT were included in the study. The prevalence of SVT was 0.48% in our unit during the study period. Six neonates (17.1%) had antenatal diagnoses of SVT. Hydrops fetalis was present in two neonates (5.7%) and congenital heart malformation in 14 (40%). Congestive heart failure developed in 11 patients (31.4%), while recurrence of SVT was documented in 17 (48.6%). SVT resolved spontaneously in four cases and with vagal maneuvers in three. The other 28 neonates required antiarrhythmic therapy. The patients were divided into groups according to the presence or absence of congestive heart failure and SVT recurrence. A statistically significant relationship was observed between the development of congestive heart failure and antenatal diagnosis of SVT (p=0.041). Statistically significant differences were also determined between the recurrence of SVT and mean heart rate (p=0.025), mean length of hospitalization (p=0.09), and prophylactic medication requirements (p=0.005). Conclusion If a neonate with SVT has a history of antenatal SVT, hydrops fetalis, recurrence, congestive heart failure, or congenital heart malformation, these conditions cause more serious morbidity and mortality.