Acta Paediatr. 2026 Feb 3. doi: 10.1111/apa.70472. Online ahead of print.
ABSTRACT
AIM: Neonatal supraventricular tachycardia lacks neonatal-specific evidence to guide therapy.
METHODS: We retrospectively collected data of neonates with supraventricular tachycardia across two Italian centres between 2014 and 2024. Clinical features, mechanisms, echocardiography, biomarkers, acute and maintenance therapy were collected; outcomes included recurrences, intensive-care admission, electrophysiology and ablation.
RESULTS: Thirty-two infants were included (59% male; median onset 14 days). Among the supraventricular tachycardia mechanisms, we identified atrioventricular reentrant tachycardia in 72%, AV-nodal reentrant tachycardia in 9%, permanent junctional reciprocating tachycardia in 9%, focal atrial tachycardia in 9%. Median ejection fraction was 60% overall and 39% in those with heart failure; tachycardia-induced cardiomyopathy occurred in 28%. First-episode termination was spontaneous in 13%, achieved with vagal manoeuvres in 28% and adenosine in 47%. Maintenance therapy was required in 97% for a median of 21 months. During a mean 3.75-year Follow-up, recurrence after withdrawal occurred in 3; electrophysiology was performed in 3 and ablation in 2. Elevated NT-pro-brain natriuretic peptide and focal atrial tachicardia/permanent junctional reciprocating tachycardia phenotypes correlated with greater therapy burden.
CONCLUSIONS: Atrioventricular reentrant tachycardia predominates in neonatal supraventricular tachycardia. While acute control is usually attainable, sustained control often requires prolonged combination therapy. Early mechanism assignment and biomarker-informed risk stratification may guide step-up treatment, and catheter ablation is a viable option for refractory cases beyond infancy.
PMID:41631441 | DOI:10.1111/apa.70472