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Atrial fibrillation in a preterm newborn with structurally normal heart
Pier Paolo Bassareo1, Andrea Raffaele Marras1, Mariangela Marras2
1Department of Medical Sciences 'M.Aresu', University of Cagliari, Cagliari, Italy.
Oxford Medical Case Reports
|July 20, 2017
Summary
Atrial fibrillation (AF) is rare in newborns. This case report details how a misplaced central venous catheter (CVC) in a neonate
Area of Science:
- Neonatal cardiology
- Pediatric electrophysiology
- Critical care medicine
Background:
- Atrial fibrillation (AF) is an uncommon cardiac arrhythmia in neonates.
- Neonatal intensive care units (NICUs) manage high-risk newborns, including those with twin-to-twin transfusion syndrome.
Observation:
- Continuous electrocardiographic monitoring in a 1-day-old infant revealed unexpected atrial fibrillation.
- Diagnostic imaging (chest X-ray, echocardiography) identified anomalous placement of a central venous catheter (CVC) tip within the heart chambers.
Findings:
- The CVC tip traversed from the umbilical artery to the inferior vena cava, right atrium, patent foramen ovale, and left atrium.
- Atrial fibrillation resolved immediately upon removal of the malpositioned CVC.
Implications:
- Mechanical irritation from a malpositioned CVC is a potential trigger for neonatal atrial fibrillation.
- This case highlights the importance of vigilant monitoring and prompt CVC repositioning in neonates to prevent cardiac complications.
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