Key result
Active postnatal arrhythmia is linked to ~10-fold higher post-discharge antiarrhythmic therapy needs than resolved cases.
Why the study?
Non-benign neonatal arrhythmias constitute a significant clinical burden in neonatal intensive care units, but the impact of prenatal diagnosis and postnatal persistence patterns on clinical outcomes has not been fully elucidated.
Does active postnatal arrhythmia (fetal persisting or neonatal only) increase clinical burden and post-discharge antiarrhythmic treatment requirement compared to fetal resolved arrhythmia in newborns with non-benign neonatal arrhythmias?
Observational (n=35)
No
Does active postnatal arrhythmia (fetal persisting or neonatal only) increase clinical burden and post-discharge antiarrhythmic treatment requirement compared to fetal resolved arrhythmia in newborns with non-benign neonatal arrhythmias?
Newborns with active postnatal arrhythmias (either persistent from fetal life or newly emerging postnatally) experience significantly higher hospitalization burden, comorbidities, and need for post-discharge antiarrhythmic therapy (>90%) compared to those whose fetal arrhythmias resolve by birth.
Neonates with active postnatal arrhythmia may need extended post-discharge therapy; leaves open optimal monitoring and intervention strategies.
Background: Non-benign neonatal arrhythmias (NAs) can constitute a significant clinical burden in neonatal intensive care units (NICUs); however, the impact of prenatal diagnosis and postnatal persistence patterns on clinical outcomes has not been fully elucidated.Objective: To evaluate the clinical burden, acute intensive care requirement, and post-discharge antiarrhythmic treatment need in non-benign NAs according to prenatal arrhythmia history and postnatal persistence pattern.Methods: This retrospective observational study included newborns diagnosed with non-benign arrhythmia during the fetal and/or neonatal period at a tertiary NICU between July 2020 and July 2025. Patients were categorized into three groups: fetal persisting (arrhythmia detected in the fetal period and persisted postnatally), fetal resolved (fetal arrhythmia resolved after birth), and neonatal only (arrhythmia emerged exclusively during the neonatal period). Clinical outcomes, treatment requirements, and adenosine response were compared between groups.Results: Of 9,210 NICU admissions, 35 cases (0.38%) with non-benign NA were identified. Supraventricular tachycardia was the most common arrhythmia type (66.7%) Groups with active postnatal arrhythmia (fetal persisting and neonatal only) demonstrated longer hospitalization, higher comorbidity rates, and greater post-discharge antiarrhythmic treatment requirement (90.9% and 92.3%, respectively) compared to the fetal resolved group (9.1%). Potassium levels were significantly higher in adenosine-resistant cases (median 5.4 vs. 4.3 mEq/L, P = 0.044).Conclusions: In this cohort, active postnatal arrhythmia, whether persistent from the fetal period or emerging only after birth, was associated with greater clinical burden and post-discharge antiarrhythmic treatment requirement than fetal arrhythmia that resolved postnatally. The observed association between higher potassium levels and adenosine resistance should be interpreted cautiously as an exploratory finding.
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Saraç et al. (2026) conducted an observational in Non-benign neonatal arrhythmias (n=35). Active postnatal arrhythmia (fetal persisting or neonatal only) vs. Fetal resolved arrhythmia was evaluated on Post-discharge antiarrhythmic treatment requirement. Active postnatal arrhythmia had greater post-discharge antiarrhythmic treatment needs (90.9% fetal persisting, 92.3% neonatal only) vs fetal resolved arrhythmia (9.1%).
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