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Successful treatment of chaotic atrial tachycardia with oral flecainide
L Houyel1, A Fournier, A Davignon
1Division of Pediatric Cardiology, Sainte-Justine Hospital, Montreal, Canada.
Insights
Oral flecainide successfully treated two infants with chaotic atrial tachycardia, even when heart failure was present. Both infants recovered normal heart function and stopped medication without recurrence.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Pharmacology
Background:
- Chaotic atrial tachycardia (CAT) is a rare and potentially serious supraventricular tachycardia in neonates.
- Infantile heart failure can be a complication of persistent tachyarrhythmias.
Observation:
- Two neonates presented with chaotic atrial tachycardia (CAT) diagnosed at birth and at 11 weeks of age.
- Both infants exhibited signs of heart failure upon presentation and initiation of treatment.
Findings:
- Successful treatment of both infants was achieved using oral flecainide.
- Following treatment, neither infant experienced a recurrence of chaotic atrial tachycardia (CAT).
- Left ventricular function normalized in both patients over follow-up periods of 6 and 17 months.
Implications:
- Oral flecainide is a viable and effective therapeutic option for chaotic atrial tachycardia (CAT) in infants, even in the presence of heart failure.
- Early and successful management of CAT can lead to complete recovery of cardiac function.
- Discontinuation of antiarrhythmic therapy may be possible after successful treatment and normalization of cardiac function.
Abstract:
Two infants with chaotic atrial tachycardia diagnosed at birth and at 11 weeks of life, were treated successfully with oral flecainide. Both patients were in heart failure at initiation of therapy. Six months and 17 months later, respectively, they have had no recurrence of chaotic atrial tachycardia, left ventricular function returned to normal and therapy was stopped in both.