Structured inpatient evaluation of neonatal cardiac ectopy

Objective(s) In well-appearing newborns with suspected cardiac ectopy, we sought to evaluate our practice and test whether initial electrocardiogram (ECG) findings were associated with neonatal arrhythmias (NA). Study design We identified well-appearing, non-anomalous infants >34 weeks’ gestation with suspected ectopy over 3.5 years. NA was defined as ≥10% premature atrial contractions (PAC), ≥5 beats of atrial tachycardia, ≥2% premature ventricular contractions (PVCs), or ≥3 beats of ventricular tachycardia. The unadjusted associations between initial ECG findings and NA are reported. Result Among 126 infants with ECGs and Holters performed, NA was observed in 38 patients (30%) and was similar whether PACs were present or not on the initial ECG (33% vs. no PACs: 29%, p = 0.6). However, NAs were identified more frequently based on the presence of PVCs on the initial ECG (83% vs. 25%, p < 0.01). Conclusion NAs were prevalent and both their etiologies and impact on infants warrant future study.