Prognosis of individual risk of heart rhythm disturbances and conductivity in newborns in the early neonatal period

Abstract

Background. In the majority of cases neonatal arrhythmias have a good prognosis for recovery. However, they can also have an adverse course and lead to development of lifethreatening conditions. Therefore, it is important to search for earlier markers of myocardial lesion, diagnostic criteria and predictors of arrhythmias. Purpose. Improvement of diagnosis and prediction of the risk of cardiac arrhythmias and conduction in newborns in the early neonatal period by identifying factors that play a role in the prediction of neonatal arrhythmias. Subjects and Methods. The study involved 76 newborns. Group 1 included 57 infants with arrhythmias according to Holter monitoring, Group 2 included 19 infants without arrhythmias. The history data, laboratory and instrumental findings, levels of troponin I and copeptin were compared. To predict development of neonatal arrhythmias, logistic regression analysis was performed. The quality of the model was tested using the Percent Concordant (PC). Quality Score was evaluated by R2 Nigelkerke. Model adequacy was estimated using the Hosmer–Lemeshow test. Results. The study showed that the factors that can influence development of arrhythmias in the early neonatal period are the level of umbilical cord blood, the levels of troponin I, copeptin, GGT, assessment of Apgar scale in the 1st and 5th minutes, asphyxia at birth, indices of wave R amplitude in V3 and V5 of chest leads, ST segment deviation from the isoline according to standard surface ECG, QTc levels and mean daily maximum, minimum heart rate according to Holter monitoring. Conclusions. Predictors of neonatal arrhythmias development are indicators of laboratory-instrumental parameters of cardiovascular system status, troponin I level above 0.29 ng/ml and copeptin level above 0.1 ng/ml.