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      Trastornos del ritmo en el recién nacido Translated title: Abnormalities of heart rhythm in newborns

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          Abstract

          Las arritmias son una variedad de alteraciones del ritmo cardiaco que se pueden presentar en fetos y en recién nacidos considerados como sanos. La mayoría de éstas son benignas. La incidencia informada varía de 1 a 10% en recién nacidos durante los primeros días de vida extrauterina. Las arritmias en la etapa neonatal implican altas morbilidad y mortalidad, sobre todo cuando se producen en pacientes con una cardiopatía congénita o con falta de respuesta al tratamiento médico. El oportuno control farmacológico del ritmo proporciona un buen pronóstico a largo plazo. La historia natural de las arritmias en el período neonatal difiere de las arritmias en otros grupos de la edad pediátrica; se pueden clasificar en: arritmia sinusal, taquiarritmias, síndrome de QT prolongado y bradiarritmias. Es importante que los médicos que se encargan del tratamiento de este grupo de pacientes reconozcan los factores causantes de las arritmias, así como las opciones diagnósticas y terapéuticas disponibles.

          Translated abstract

          Arrhythmias are a variety of cardiac rhythm disturbances that may occur in fetuses and neonates considered healthy. Most of these are benign. The reported incidence fluctuates from 1 to 10% in newborns during the first days after birth. The presence of arrhythmias in the neonatal period involves high morbidity and mortality, particularly when associated with congenital heart disease or lack of response to medical treatment. The appropriate pharmacological control of the abnormal rhythm provides good long-term prognosis. The natural history of arrhythmias in the neonatal period differs importantly from arrhythmias presented in other pediatric age groups. They can be classified as: sinus arrhythmia, tachyarrhythmias, long QT syndrome and bradyarrhythmias. It is important that the physicians responsible for the management of these patients recognize the causes for the development of arrhythmias as well as the diagnostic and therapeutic options available

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          Most cited references24

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          Ventricular tachycardia in neonates.

          J Perry (1997)
          Infant VT can be a devastating arrhythmia, with high mortality for those presenting with myocarditis, long QT syndrome, or cardiovascular collapse with rapid VT due to tumors. While management of these patients can be challenging and discouraging, other infants with wide QRS rhythms tend to follow a more benign course. These latter patients have accelerated idiopathic ventricular rhythm or aberrant forms of infant supraventricular tachycardia. Distinguishing these forms of wide QRS tachycardia from the more lethal forms is paramount to institution of appropriate therapies.
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            Arrhythmias in the newborn

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              Epidemiology and Outcome of Tachyarrhythmias in Tertiary Pediatric Cardiac Centers

              Introduction: Little is known about the real importance of pediatric arrhythmias. Methods: We analyzed the epidemiology, presentation and outcome of all clinically relevant tachyarrhythmias followed up in our pediatric institutions from 1995 to 2006. Results: A total of 250 cases were identified. The mean age ± SD at diagnosis was 4.7 ± 5.3 years, 45 cases were neonatal (18%). Supraventricular arrhythmias were noted in 210 children (84%), ventricular arrhythmias in 40 (16%). The most frequent symptoms were palpitations (n = 71) and syncope (n = 48) in older children, as well as monitoring of diseases (n = 62) and heart failure (n = 49) in younger patients. Recurrence was noted under or after therapy in 75 cases, mostly in cases diagnosed beyond infancy. At long-term follow-up, 169 patients have no recurrence without treatment (of whom 34 had required catheter ablation), 71 are under therapy and 10 died. Conclusion: Supraventricular arrhythmias in younger children are often an incidental diagnosis, respond to antiarrhythmic therapy and have a high incidence of resolution. In older children with supraventricular arrhythmias and in those with ventricular arrhythmias, delayed diagnosis or misdiagnosis is not rare, the arrhythmias are unlikely to resolve spontaneously and long-term antiarrhythmic treatment or catheter ablation is necessary.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                apm
                Acta pediátrica de México
                Acta pediatr. Méx
                Instituto Nacional de Pediatría
                2395-8235
                April 2014
                : 35
                : 2
                : 148-158
                Affiliations
                [1 ] Instituto Nacional de Pediatría
                [2 ] Instituto Nacional de Pediatría México
                Article
                S0186-23912014000200009
                5c2e2de4-fc9e-48e1-8eb3-f4184bb41318

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Categories
                Pediatrics

                Pediatrics
                síndrome de QT prolongado,arritmias,recién nacidos,arritmia sinusal,taquiarritmias,tratamiento,pronóstico,arrhythmia,newborns,sinus arrhythmia,tachyarrhythmias,long QT syndrome and bradycardia

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