Ventricular arrhythmias

A spectrum of distinctive clinical presentations and electrocardiographic p atterns have been recognized in neonates with ventricular arrhythmias. Thes e may range from an incidental finding on a routine physical to cardiovascu lar collapse due to ventricular fibrillation. It has become increasingly im portant that the clinician considers ventricular tachycardia in the neonate with tachycardia when the QRS normal does not appear normal. In general, i solated premature ventricular depolarizations, couplets and non-sustained v entricular tachycardia in the absence of heart disease are associated with a favorable prognosis. Most of these arrhythmias tend to resolve during the first month of life. Conversely, sustained ventricular arrhythmias associa ted with ischemia, myocarditis or ventricular tumors are associated with a guarded prognosis. Treatment is based on the definition of associated cardi ovascular disease, support of hemodynamic status and the judicious use of a ntiarrhythmic agents. Finally, there has been an increased recognition of i diopathic forms of ventricular tachycardia in the neonate which are associa ted with a favorable prognosis and may not require pharmacologic treatment. This review will discuss these arrhythmias in neonates, associated forms o f cardiovascular disease, current treatment options and long-term prognosis . (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.