Arrhythmias in Neonates and Infants at a Tertiary Care Center.

• Authors: Marwan Refaat, Cardiovascular Disease, American University of Beirut, Beirut, LBN.; Mostafa M Abohelwa, Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA.; Mohamed Ahmed, Family Medicine, American University of Beirut, Beirut, LBN.; Amr Elgehiny, Pediatrics, University of Texas Health Science Center at Houston, Houston, USA.; Maryam Ibrahim, Internal Medicine, American University of Beirut Medical Center, Beirut, LBN.; Patrick Zakka, Emory University; Islam El Rassi, Cardiac Surgery, American University of Beirut, Beirut, LBN.; Ziad Bulbul, Pediatric Cardiology, American University of Beirut, Beirut, LBN.; Fadi Bitar, Pediatric Cardiology, American University of Beirut, Beirut, LBN.; Mariam Arabi, Cardiology, American University of Beirut, Beirut, LBN.
• Journal Title: Cureus
• Volume: Volume 13, Number 1
• Publisher: Cureus | 2021-01-22, Pages e12861-e12861
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.7759/cureus.12861
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: arrhythmias; congenital heart disease; infants; neonates

Abstract

Background Limited data about arrhythmias in neonates and infants are coming out from the Middle East. Objectives To evaluate different types of arrhythmias in neonates and infants at the American University of Beirut Medical Center (AUBMC), a tertiary care center in Lebanon, with the focus on the nature of arrhythmia, treatment modalities and relation to surgery. Methods Data were collected retrospectively from the hospital records. We included all neonates and infants presenting to AUBMC between 2013 and 2017. Collected data included: the type of arrhythmia, the treatment modality used and its success, the need for additional modes of treatment, the relationship to congenital heart diseases, and the cardiac surgeries performed. Results Of 16,346 subjects admitted to AUBMC between 2013 and 2017, 90 subjects developed arrhythmias that required medical intervention. The most frequent types of arrhythmias were supraventricular tachycardia (62.22%), junctional ectopic tachycardia (13.33%), complete heart block (7.78%), atrial flutter (5.56%), multifocal atrial tachycardia (3.33%), Wolf Parkinson White Syndrome (3.33%), non-sustained ventricular tachycardia (2.22%), sinus pause (1.11%), and premature ventricular contractions (1.11%). Bivariate analysis showed a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in terms of the type of arrhythmia developed, the presence of congenital heart defect, prematurity, and electrolyte disturbances (P-value <0.005). However, multivariate logistic regression showed no significant difference between the two groups after adjustment for the significant variables (P-value > 0.05). Conclusion There is a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in neonates and infants at AUBMC. However, the difference disappears after adjusting for different variables.