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Atrial flutter in the neonate and early infancy
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Japanese Heart Journal
|August 26, 1998
Summary
Neonatal atrial flutter, a rare heart rhythm, often resolves with treatment like digoxin or cardioversion. Most infants achieve normal sinus rhythm with a good long-term prognosis, suggesting long-term digoxin may not be needed.
Area of Science:
- Pediatric Cardiology
- Neonatal Electrophysiology
Background:
- Atrial flutter is an uncommon cardiac arrhythmia in neonates and infants.
- Early diagnosis and management are crucial for favorable outcomes.
Purpose of the Study:
- To review the clinical characteristics, treatment strategies, and long-term outcomes of atrial flutter in neonates.
- To evaluate the efficacy of different therapeutic interventions and assess recurrence rates.
Main Methods:
- Retrospective review of seven neonates diagnosed with atrial flutter.
- Analysis of clinical presentation, echocardiography findings, treatment modalities (electrical cardioversion, digoxin), and follow-up data.
Main Results:
- Atrial flutter onset ranged from 1 day to 3 months; four cases diagnosed within the first 3 days of life.
- Three patients had 2:1 atrioventricular conduction, four had variable atrioventricular block; three presented with heart failure.
- Five of six treated patients converted to normal sinus rhythm within 2 days; no recurrences observed during 6 months to 7 years of follow-up.
Conclusions:
- Neonatal atrial flutter generally has a good long-term prognosis.
- Electrical cardioversion and digoxin appear effective for acute treatment.
- Long-term digoxin prophylaxis after rhythm conversion may not be necessary for most patients.