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Multiple external electrical cardioversions for refractory neonatal atrial flutter.

Simone Gulletta¹, Rosanna Rovelli, Rossana Fiori

¹Department of Cardiology, San Raffaele University Hospital, Milan, Italy. gulletta.simone@hsr.it

Pediatric Cardiology

|October 4, 2011

Summary

This summary is machine-generated.

This case study details a fetal/neonatal patient with atrial flutter resistant to standard treatments. Successful cardioversion was achieved with propafenone premedication, with no recurrence during follow-up.

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Area of Science:

Cardiology
Neonatal Medicine
Pediatric Electrophysiology

Background:

Atrial flutter is a rare but serious arrhythmia in neonates.
Standard treatment protocols may be ineffective in refractory cases.
Fetal/neonatal atrial flutter requires tailored therapeutic approaches.

Observation:

A neonate presented with persistent atrial flutter unresponsive to adenosine and multiple external cardioversions.
Initial propafenone bolus did not resolve the arrhythmia.
The patient required additional interventions for rhythm control.

Findings:

A fourth direct current cardioversion, preceded by propafenone premedication, successfully terminated the atrial flutter.
Continuous propafenone therapy prevented arrhythmia recurrence over a 12-month follow-up period.
This suggests a potential role for propafenone in managing refractory neonatal atrial flutter.

Implications:

Propafenone premedication may be a viable strategy for intractable fetal/neonatal atrial flutter.
This case highlights the need for individualized treatment plans in pediatric arrhythmias.
Further research is warranted to establish optimal management guidelines for this condition.