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[Atrial flutter in neonates and infants: diagnosis and treatment]
Fatma Ouarda1, Héla M'Saad, Lilia Chaker
1Service de Cardiologie Pédiatrique, Hôpital la Rabta, Tunis.
Insights
Atrial flutter in neonates and infants is a rare but serious condition. While some infants responded to treatment, two neonates died, highlighting the condition's severity.
Area of Science:
- Pediatric Cardiology
- Neonatal Arrhythmia
- Cardiac Electrophysiology
Context:
- Atrial flutter is a rare supraventricular tachyarrhythmia.
- Diagnosis and management in neonates and infants present unique challenges.
- Limited data exists on atrial flutter in this specific pediatric population.
Purpose:
- To describe the clinical characteristics, management, and outcomes of atrial flutter in neonates and infants.
- To evaluate the efficacy of cardioversion and amiodarone in treating pediatric atrial flutter.
- To highlight the rarity and seriousness of atrial flutter diagnosed in the neonatal period.
Summary:
- Five patients (3 infants, 2 neonates) were treated for atrial flutter.
- Diagnosis was confirmed via 12-lead electrocardiogram; all patients had structurally normal hearts.
- Cardioversion was successful in 3 patients; amiodarone showed good impregnation in 2.
- Two neonates died within 10 days of life; one infant experienced recurrent episodes.
- The underlying mechanism of atrial flutter in fetuses, neonates, and infants remains unknown.
Impact:
- This study underscores the critical nature of atrial flutter in the neonatal period.
- Findings suggest a need for further research into the pathophysiology and optimal treatment strategies.
- Early diagnosis and intervention are crucial for improving outcomes in affected infants.
Abstract:
Between 1995 and 2002, 5 patients with a mean age of 32 years have been treated for atrial flutter in the Department of Paediatric Cardiology at Hospital La Rabta. In all cases, diagnosis was established on surface electrocardiogram (12 leads. All patients had a normal heart. The 3 infants were in heart failure and In the 2 neonates, the arrhythmia was well tolerated despite a very fast ventricular rate. Reduction of the first episode of atrial flutter was possible by cardioversion in 3 patients, 2 of them had a good impregnation with Amiodarone. The two neonates died at 8th and 10th day of life. In the long term follow-up, on infant presented two recurrent episodes at 4 months x 2 years. Atrial flutter, when diagnosed in neonatal period is a rare but serious rhythm disturbance. The mechanism of activation of this rhythm disturbance remains unknown in the foetus, neonate and infant.