Influencing factors of cardiac insufficiency caused by neonatal arrhythmia / 中国小儿急救医学

ABSTRACT

Objective:To explore the clinical characteristics of neonate with arrhythmia and the potential risk factors for cardiac insufficiency.Methods:Research data were collected from the cases of neonate with arrhythmia from January 2017 to June 2021 at the Neonatology Department at Children′s Hospital Capital Institute of Pediatrics.A retrospective analysis was conducted to summarize the clinical features and analyze the risk factors of arrhythmia leading to cardiac insufficiency.Results:A total of 90 cases were enrolled, with a male to female ratio of 1.43∶1(53∶37), and the median gestational age was 39(37, 40)weeks; with 16(17.8%) premature infants, 74 full-term infants(82.2%), and the median onset age was 3(0, 11)days.In this group, 63.3% cases(57/90)were irregular rhythmic arrhythmias, of which 66.7%(38/57)were atrial premature contractions, 23.3%(21/90) were tachyarrhythmias, and 13.3%(12/90)were bradyarrhythmias.Additionally, 80.0%(72/90)of the cases had no typical clinical manifestations.Besides, 37.7%(34/90)of the patients had single infection factor, and 4.4%(4/90)of the patients had infection with perinatal hypoxia asphyxia.The ratio of the premature birth, maternal autoimmune diseases and the tachyarrhythmia were higher in heart failure group than those in normal heart function group(71.4% vs.13.3%, P<0.001; 28.6% vs.3.6%, P=0.006; 100% vs.16.9%, P<0.001). The random forest model showed that the factors of premature delivery and maternal autoimmune disease had the greatest influence on cardiac function, and the analysis of 21 tachyarrhythmias showed that the duration of arrhythmia had the greatest influence on cardiac function. Conclusion:Atrial premature contraction is the most common in neonate with arrhythmia, and with non-typical clinical manifestations.The infection and the infection combined with perinatal asphyxia are the main influencing factors of neonate with arrhythmia.Premature delivery, maternal autoimmune disease and the duration of tachyarrhythmias are the main risk factors of neonatal arrhythmias leading to cardiac dysfunction.