treating SVTs in newborn babies

[Rasa B]

Hello! We have term baby with congenital supraventricular tachycardia(no WPW). SVT attacks were associated with poor perfusion and difficult to convert with adenosine. Cardioversion was innefective either. After reversion with amiodarone sinus rhytm was of 80bpm with second degree AV block for about 3 days. Could anybody share the practice of treating SVTs in newborn babies(protocols or internet links), drugs of choice for preventing attacks(our pediatric cardiologist recommends propafenone) etc. Thank you.

[Alexander Rakow]

Check this article out:
Neonatal tachycardias: an update, by Kothari & Skinner
Archives of Disease in Childhood 2006;91:F136-F144

(if you upgrade to a Premium Membership (http://www.99nicu.org/forum/showthread.php?t=136) you can read this article in full text!)

[Rasa B]

I got full text. Very helpful. Thank you.

[Stefan Johansson]

As I recall it, our cardiologists mainly use Sotalol and Flecainide for supraventricular takyarytmias.

[JACK]

I remember one very resistant SVT in one newborn with CCF. At last it responded to Digoxin.

[JACK]

Let me update this thread.
The paper which was mentioned here:

Check this article out:
Neonatal tachycardias: an update, by Kothari & Skinner
Archives of Disease in Childhood 2006;91:F136-F144


is now available free at Link (http://fn.bmj.com/cgi/content/full/91/2/F136) . The only condition is that you do a registration which is free and takes a few minutes.

Some other related papers to this topic which are available free to all are:

1) Dixon, J, K Foster, J Wyllie, and C Wren. “Guidelines and adenosine dosing in supraventricular tachycardia.” Arch Dis Child 90, no. 11 (November 1, 2005): 1190-1191.
LINK (http://adc.bmj.com/cgi/reprint/90/11/1190?ijkey=a266d5f3feac7418b5e27481110d98ab4029bb6 9)

2) Rosenthal, E. “Pitfalls in the use of adenosine.” Arch Dis Child 91, no. 5 (May 1, 2006): 451-a.
LINK (http://adc.bmj.com/cgi/reprint/91/5/451-a)

There are three recent ariticles regarding this topic. Unfortunately you will need a subscription to see the full article:

1) 1. Novo S, Barbaro G. Current trends in the treatment of supraventricular tachycardia in pediatric age. Curr. Pharm. Des. 2008 ;14(8):722-22.
LINK (http://www.ingentaconnect.com/content/ben/cpd/2008/00000014/00000008/art00001?token=004a1206766e58654624404442316b415d3 b783c24455e4e26634a492f253033297663a4e4)

2) 1. Gilljam T, Jaeggi E, Gow RM. Neonatal supraventricular tachycardia: outcomes over a 27-year period at a single institution. Acta Paediatr. 2008 May 16; LINK (http://www3.interscience.wiley.com/journal/120122536/abstract?CRETRY=1&SRETRY=0)

3) 1. Knirsch W, Kretschmar O, Vogel M, Uhlemann F, Bauersfeld U. Successful treatment of atrial flutter with amiodarone in a premature neonate. Case report and literature review. Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses. 2007 Jun ;7(3):113-21.
LINK (http://www.advancesinneonatalcare.org/pt/re/anc/abstract.00149525-200706000-00008.htm;jsessionid=L4mJzpspWSLmdRchhPLQnkLX4bFbt ZQq2hJGYQV8NDhbk2lyMSRH!536197444!181195628!8091!-1)