Clinical practice guidelines: management of non-post-operative supra-ventricular tachycardia in neonates and children less than 18 years old hospitalized in a Pediatric Intensive Care Unit - 16/09/26

Doi : 10.1016/j.aicoj.2026.100160

Sophie Breinig ^a,^b,⁎ , Romain Amadieu ^a, Agathe Béranger ^c,^d, Yves Dulac ^e, Isabelle Goyer ^f, Marion Grimaud ^c, Maiwenn Le Ny ^g, Yael Levy ^h,ⁱ, Alice Maltret ^j, Christopher Marquis ^k, Soizic Paranon ^l, Morgan Recher ^m,ⁿ, Louise-Marie Jandeaux ^o, Khaldoun Kuteifan ^p, Julie Starck ^q

on behalf of the French Speaking Group for Pediatric Intensive and Emergency Care

^a Neonatal and Pediatric Intensive Care Unit, Children’s Hospital, 330 avenue de Grande-Bretagne, Toulouse Cedex 9, France

^b Center for Epidemiology and Research in POPulation health (CERPOP), UMR1295, Toulouse University, Inserm, Toulouse, France

^c Pediatric Intensive Care Unit, Necker Children’s Hospital, APHP Centre 149 rue de Sèvres, 75015 Paris, France

^d Université Paris Cité, Inserm, UMR1343, Pharmacologie et évaluations des thérapeutiques chez l'enfant et la femme enceinte, F-75006 Paris, France

^e Pediatric cardiology Unit, Children’s Hospital, 330 avenue de Grande-Bretagne, Toulouse Cedex 9, France

^f Pediatric intensive care unit, avenue Cote de nacre, 14033 Caen, France

^g Pediatric intensive care unit, 59 Boulevard Pinel, 69500 Bron, France

^h CHU La Réunion, Department of Pediatric Cardiac Intensive Care Unit, F-97400 Saint-Denis, France

ⁱ Reunion University, CHU La Réunion, INSERM, CIC-EC 1410, La Réunion, France

^j Filière des Cardiopathies Congénitales Enfant Adulte, Centre de Compétence Trouble du rythme héréditaire, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Université Paris Saclay, France

^k Pediatric intensive care unit, Montréal, QC, Canada

^l Pediatric emergency transport unit, Place Amélie Raba Léon, 33000 Bordeaux, France

^m Pediatric intensive care unit, Avenue Eugene Avinee

ⁿ Univ. Lille, CHU Lille, ULR 2694 – METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France

^o Intensive care unit, Nouvel Hôpital Civil, 1e étage, ascenseur E. 1 place de l'hôpital. BP 426. 67091 Strasbourg cedex, France

^p Service de Réanimation Médicale GHRMSA, Hôpital Emile Muller, 68100 Mulhouse, France

^q Neonatal and Pediatric intensive care unit, Trousseau Children hospital, 26 avenue du Docteur Arnold Netter, 75012 Paris, France

^⁎ Corresponding author.

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Highlights

•	Identification of criteria requiring PICU is essential for management
•	Management of SVT in neonate and children requires a step by step approach
•	Conversion to sinus rhythm can be delayed in case of tachycardia-induced cardiomyopathy

Le texte complet de cet article est disponible en PDF.

Abstract

Purpose

We present guidelines in the form of pragmatic recommendations for management of neonates and children less than 18 years old presenting with non-post-operative supraventricular tachycardia (SVT) and hospitalized in a Paediatric Intensive Care Unit (PICU).

Methods

Thirteen French-speaking experts, all of them members of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French‐speaking group of paediatric intensive and emergency care; GFRUP), collaborated from 2024 to 2025 through teleconferences and face-to-face meetings. The guidelines cover four areas: (1) epidemiology and criteria for admission to a PICU, (2) paraclinical assessment, (3) non-specific rhythm management, and (4) specific rhythm management. The questions were formulated in the Patient-Intervention-Comparison-Outcome (PICO) format. An extensive Anglophone and Francophone literature search indexed in the MEDLINE database via PubMed, Cochrane and Embase was performed using pre-established keywords. The texts were analyzed and classified according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. When this method was not applicable, an expert opinion was given. Each of the recommendations was voted on by all the experts according to the Delphi methodology.

Results

The group proposes 21 recommendations. The GRADE methodology could be applied for five of them, and an expert opinion was given for the remaining 16. All of the recommendations received strong approval.

Conclusion

These guidelines cover different aspects in the management of non-post-operative SVT in children hospitalized in PICUs including non-specific and specific rhythm management.

Le texte complet de cet article est disponible en PDF.

Keywords : non-post-operative supraventricular tachycardia, Guidelines, Recommendation, Pediatric intensive care, cardiogenic shock, amiodarone, adenosine

Abbreviations : AF, AFL, ANVRT, AVR, BNP, CPAP, DEHP, EAT, ECLS, ECMO, IV, LV, LVEDD, LVEF, NIPSV, NIV, NT-ProBNP, PJRT, PPV, PVC, SEES, SVT, TCM, TEE, TTE, VAD, WPW