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Did Your Newborn Suffer Cerebral
Palsy or Another Brain Injury Before
or During Labor and Delivery?

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Our Birth Brain Injury Resource Guide

the guide

Get a FREE guide of resources available throughout Ohio to children and families of children who were born with brain injuries.

Our guide can help you build a foundation of knowledge and tools that will help you help your child
now and in the future.

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Cooling Therapy – Abnormal Heart Rhythms

Newborn babies who are struggling to get oxygen either before or during delivery can benefit from the cooling method, provided the treatment is delivered within six hours of the infant’s life.

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During the treatment, the baby is monitored for abnormal brain activity and seizures. While the therapy may not help all babies, it does offer newborns a better outcome. However, there are several risks and complications, including abnormal heart rhythms, or arrhythmias.

About Arrhythmias

An arrhythmia is the terms used for an abnormal heart rhythm that can lead to the heart pumping less effectively. Some infants are born with heart defects that result in arrhythmias, and others develop them later on.

Premature heartbeats, or additional heart beats, are usually what cause irregular heart rhythms. The beats can begin in the atria or in the ventricles. This kind of arrhythmia feels as though the heart skips a beat, but what happens is a beat occurs a little earlier than expected, followed by a pause, and then a very strong beat. Premature heartbeats tend to be normal, but sometimes they can be an indication of damage or disease in the heart.

Bradycardia is a slow pulse and is usually caused by damage to the sinus node. It can also be caused by a heart block. When bradycardia is picked up soon after a baby is born, it can sometimes lead to a complete heart block.

Cooling Therapy and Arrhythmias

Elk & Elk

While there are very few risks and complications associated with cooling therapy, cardiac arrhythmia is one of the most common issues during the intervention.

One review that has been issued by the Cochrane Library has reported that 72 hours of moderate cooling started within 6 hours of being born, has a negative effect on heart rhythms, and the adverse effects thereof remain controversial when therapy is used in infants with HIE.

In one particular study, randomized controlled studies were used to compare the use of this type of therapy with standard care for infants with HIE.

Cooling therapy was initiated prior to six hours after birth compared to the other group of participants who did not receive therapy. The cooling lasted between 48 – 72 hours and cooled body temperatures range between 33 to 35 degrees C.

Seven trials were identified that included 1,322 infants who had HIE. It was found that cooling treatment significantly increased the rate of abnormal pulse.

Treating Arrhythmias

Many arrhythmias are isolated occurrences and do not cause harm, so they do not require treatment. However, the arrhythmia is usually treated by treating the underlying issue, such as a fever.

When treatment is needed, it will depend on the cause and type of arrhythmia. Treatment options might include:

  • Cardioversion – a procedure wherein an electrical shock is delivered, converting a fast or irregular heart rhythm to a more stable rhythm.
  • Medication – some arrhythmias do respond to medication which can be given to the baby during the therapy.
  • Radiofrequency ablation – a procedure involving cardiac catheterization that uses radiofrequency energy that is applied to the area where the arrhythmia starts, heating it and then leading to tissue death.

The Outlook

Most arrhythmias tend to be harmless and will not lead to significant health problems as the child grows up. Even serious issues can be treated, usually with the cooling therapy.