Atrial Flutter Complicating Neonatal Coxsackie B2 Myocarditis

Abstract

A neonate presented with atrial flutter complicating acute Coxsackie B2 myocarditis. The tachyarrhythmia was successfully terminated with electrocardioversion followed by digoxin administration. The infant survived with no long-term cardiac sequelae. Atrial flutter is an unusual complication of Coxsackie myocarditis that has not previously been reported.

Reversible Atrioventricular Block and Junctional Ectopic Tachycardia in Coxsackievirus B3-Induced Fetal–Neonatal Myocarditis without Left Ventricular Dysfunction

“…5 Usual arrhythmias associated with enterovirusinduced myocarditis include sinus tachycardia, supraventricular tachycardia, arterial flutter, ventricular tachycardia, and complete A-V block (Table 1). 1,[6][7][8][9][10][11][12][13][14][15] JET associated with neonatal viral myocarditis has only been reported twice. 14,16 Although amiodarone is not an established therapy for neonates, we used amiodarone in accordance with a previous report.…”

The role of Interleukin-6, its −174 G>C polymorphism and C-reactive protein in idiopathic cardiac arrhythmias in children

“…In contrast to adults, AF occurs incidentally in children, and a potential role of inflammatory factors and their genetic determinants in arrhythmias in children has not been studied in a larger group of patients. There have been reports showing links between cardiac arrhythmias in children, mainly neonates, and viral infections, including acute Coxsackie B2 myocarditis [17], influenza B virus infection [18], varicella [19], as well as enterovirus and influenza A myocarditis [20], usually complicated by cardiac dysfunction. Arrhythmia, due to viral infection, may be responsible in some cases for sudden infant death syndrome (SIDS), when viral and bacterial toxins induce cytokine activity [21].…”

“…A low prevalence of cardiac arrhythmias in children contributes to the fact that our understanding of their etiology and pathogenesis is limited. The condition may occur in all age groups, including the fetus and neonates [17,19].…”

Recurrent supraventricular arrhythmias in a dog with atrial myocarditis and gastritis

“…Coxsackie virus causes gastroenteritis in human beings, and this organism has been shown to directly infect the myocardium, producing a deleterious immune response (Hashimoto and Hagiwara 1986). The immune response, either via molecular mimicry or by production of damaging cytokines, can subsequently injure the myocardium and produce arrhythmias including atrial flutter and AF (Shah and others 1998). Arrhythmias may persist long after the inciting viral infection has resolved.…”