Chantepie A, Ramponi N, Vaillant M C, Laugier J, Raynaud P, Fauchier J P
Arch Mal Coeur Vaiss. 1986 Aug;79(9):1371-5.
The authors report a case of polymorphic supraventricular tachycardia in a premature neonate born at 33 weeks by caesarean section because of foeto-placental insufficiency and hydramnios due to foetal tachycardia diagnosed in utero. This arrhythmia was of interest because of the association of chaotic atrial tachycardia and the Wolff-Parkinson-White syndrome (WPW), which has rarely been described in the neonate. The mechanism of atrial tachycardia in the WPW syndrome is variable. In our case, there was retrograde atrial activation by the accessory pathway with atrial desynchronisation aided by left atrial dilatation. Digoxin, an effective anti arrhythmic agent in neonatal tachycardia, should not be used in cases of atrial tachycardia associated with ventricular preexcitation because of the risk of dangerous ventricular tachycardia.
作者报告了一例33周剖宫产出生的早产新生儿发生多形性室上性心动过速的病例,该新生儿因胎儿-胎盘功能不全和宫内诊断为胎儿心动过速导致羊水过多而出生。这种心律失常很有意思,因为它合并了紊乱性房性心动过速和预激综合征(WPW),而这在新生儿中很少被描述。WPW综合征中房性心动过速的机制是可变的。在我们的病例中,存在经旁路的逆向心房激动,同时左心房扩张辅助心房不同步。地高辛是新生儿心动过速的有效抗心律失常药物,但对于伴有心室预激的房性心动过速病例不应使用,因为存在发生危险室性心动过速的风险。