Neonatal and Infant Tachyarrhythmias: Differentiation and Treatment

Cardiac arrhythmia recognition is essential in the neonatal population, because premature newborns are at risk for arrhythmias due to immature heart muscle, function, and congenital heart abnormalities. An increased heart rate is the appropriate reaction to stress, and some tachycardias can lead to congestive heart failure or death if not treated appropriately. Although bradycardia is the most frequently seen arrhythmia in the newborn period, four additional arrhythmias may occur in the neonatal and infant populations: sinus tachycardia, supraventricular tachycardia, ventricular tachycardia, and complete heart block. As the tachyarrhythmias appear similar on the monitor, the treatment of each is very different. The nurse must be able to differentiate them. The nurse must take the initiative to discern the differences between the arrhythmias, have complimentary assessment skills to determine the severity of the associated signs, and be able to communicate this to the care provider to ensure appropriate treatment. An educated nurse is the most important link in this process.