A Case Series of Neonatal Arrhythmias at Multiple Centres in North Maharashtra, India

Background: Neonatal arrhythmias (NAs) refer to abnormal heart rate and rhythm in the neonatal period. Various inherent cardiovascular, systemic, or metabolic abnormalities can precipitate NAs. We sought to evaluate the incidence, types, and implications of NAs. Methods: A retrospective observational study was performed on newborns diagnosed with NAs during hospitalization in ۴ neonatal intensive care units (NICUs) in North Maharashtra, India, from May ۲۰۱۸ to June ۲۰۲۱.  Results: During the study period, ۴۲ neonates with arrhythmias were identified. The incidence of arrhythmias was ۰.۶۷% in the ۴ NICUs. Their mean gestational age was ۳۶ weeks (Range: ۲۹–۴۲ weeks). Eighteen of the infants (۴۲.۸۵%) were diagnosed with fetal arrhythmia (FA) during the third trimester of pregnancy. The distribution of NA types was as follows: ۱۲(۲۸.۵۷%) supraventricular tachycardia (SVT), ۱۲(۲۸.۶۷%) premature atrial contractions (PACs), ۷(۱۶.۶۷%) premature ventricular contractions (PVCs), ۳(۷.۱۴%) multiple arrhythmias such as SVT+PAC and AV block+PVC, and ۶(۱۴.۲۸%) with AV block. The Wolff-Parkinson-White syndrome (WPW) was present in ۲ patients. An association of NAs with congenital heart defects was identified in ۱۸ cases.  Conclusions: Non-benign cardiac arrhythmias are significant causes of infant morbidity and even mortality if undiagnosed and untreated. The pediatrician must know the etiology, development, and natural history of arrhythmias in the fetal and neonatal periods.