Yenidoğan Supraventriküler Taşikardilerinin İzlemi ve Transösofageal Elektrofızyolojik Çalışma Uygulaması Sonuçlarının Geriye Dönük Değerlendirilmesi

Abstract

Ismayılova A. Neonatal supraventricular tachycardia (SVT) and retrospective assessment of transesophageal electrophysiologic study (TEEPS) outcomes. Research”, Hacettepe University Faculty of Medicine, Department of Pediatrics, Dissertation Thesis, Ankara, 2016. This study aimed to evaluate 56 infants who are hospitalised in Neonatal Intensive Care Unit and diagnosed with neonatal arrhythmia between 1994 and 2016. Types of arrhythmia, presence of fetal arrhythmia, pharmaceutical therapy at discharge and TEEPS outcomes are evaluated retrospectively. 94 patiens were detected who were diagnosed with arrhythmia, 14 of whom were hospitalised for fetal arrhythmia but did not develop any arrhythmia after birth. The 20 patients diagnosed with arrhythmia other than supraventricular tachycardia and the 4 patiens whose information could not be obtained were exluded and the remaining 56 patients were included in the study. Male-to-female ratio was 2.1:1. Median follow-up time was 7,1±4,7 years ( 2 months- 22 years). One patient died during the neonatal period due to arrhthmia. TEEPS was performed on 30 patients who were followed up with neonatal SVT. 13 of them were at the neonatal period and one procedure was at 6 year of age; totally 14 procedures performed with diagnostic and therapeutic purpose. The remaining 16 procedures were performed to stop pharmaceutical therapy. There were no observed complications. Pharmaceutical therapy was stopped in 15 patients whose tachyicardia was not stimulated with TEEPS, in 4 successfully ablated patients and in 5 patients according to Holter EKG follow-ups. The patients were evaluated into two groupsmaccording with therapeutic intensity. Group 1 consisted of 25 patients who were followed with one medication or without any medication. Group 2 consisted of 31 patients who were on combination drug therapy, this group was evaluated as resistant SVT. The two groups were compared according to sex, gestational age, fetal diagnosis, tachycardia-related cardiomyopathy, presence of congenital heart disease and usage of amiodaron therapy. Amiodaron use, hospitalization duration, tachycardia-related cardiomyopathy was higher in Group 2, respectively (p<0,05). TEEPS procedure was shown to be safe and useful to demostrate etiology of arrhythmia and to make pharmaceutical therapy desicions.