Réduction d’un flutter atrial néonatal récidivant par chocs de cardioversion et amiodarone

Neonatal atrial flutter is a rare entity seen in the newborn period. With prompt treatment, they mostly revert to normal rhythm, with good long-term prognosis. But prolonged untreated atrial flutter can result in heart failure. This necessitates prompt diagnosis and treatment of the condition. However, all available treatment modalities are not effective in all patients. Here, we report 2 newborns with atrial flutter who did not respond initially to medical management, but eventually responded to cardioversion, with good outcome.

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Neonatal Atrial Flutter: Case Report

Chandraprakasam

Muralidharan

Kannan

2021

Journal of Neonatology

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Abordagem de Flutter Atrial Neonatal: Uma Série de Casos

Valente

Góes

Fabro

et al. 2020

J Cardiac Arrhtythmias

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Objetivo: Este estudo teve como objetivo analisar as opções terapêuticas dos pacientes com flutter atrial (FLA) neonatal, considerando os métodos diagnósticos disponíveis e o prognóstico desses pacientes. Metodologia: Foi realizado um estudo retrospectivo através da revisão dos prontuários de uma série de sete pacientes com fibrilação atrial (FA) diagnosticada durante o período fetal ou neonatal. O tempo de seguimento desses pacientes variou de 7 meses a 3 anos e 8 meses (média: 1 ano). Os dados clínicos para o diagnóstico incluíram frequência cardíaca sustentada superior a 180 bpm, que foi confirmada em todos os pacientes por um eletrocardiograma de 12 derivações. Resultados: Quatro (57,1%) dos sete pacientes estudados eram do sexo masculino. A maioria dos pacientes revelou arritmia cardíaca durante o período intrauterino, quando examinados por ultrassom fetal no terceiro trimestre de gestação (5 pacientes, ou seja 71,2%). Apenas à mãe do Paciente 2 foi administrada digoxina antes do parto. A taxa atrial da taquiarritmia revelou uma média de 375 bpm, com um aumento de até 500 bpm. A condução atrioventricular apresentou uma relação de 2:1 em todos os pacientes, com variações de 3:1 e 4:1 observadas nos Pacientes 1, 3 e 6. A frequência ventricular variou de 188 a 250 bpm. Todos os pacientes revelaram características típicas e anti-horárias do eletrocardiograma. A cardioversão elétrica sincronizada foi o tratamento de escolha em 6 pacientes (85,7%), com uma dose de 1 J/kg. Conclusão: Diagnóstico precoce, tratamento prévio e cardioversão elétrica sincronizada indicam um excelente prognóstico, e o tratamento de manutenção prolongada pode ser desnecessário.

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Neonatal Atrial Flutter Approach: A Case Series

Valente

Góes

Fabro

et al. 2020

J Cardiac Arrhtythmias

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Objective: This study set out to analyze the therapeutic options of patients with neonatal atrial flutter (AFL), considering the diagnostic methods available and the prognosis of these patients. Methodology: A retrospective study was performed by reviewing the medical records of a series of seven patients with atrial fibrillation (AF) diagnosed during fetal or neonatal period. The follow-up time of these patients ranged from 7 months to 3 years and 8 months (mean: 1 year). The clinical data for the diagnosis included sustained heart rate greater than 180 bpm, which was confirmed in all patients by a 12-lead electrocardiogram. Results: Four (57.1%) of the 7 patients studied were male. Most of the patients revealed cardiac arrhythmia during the intrauterine period when screened by fetal ultrasound in the third trimester of gestation (5 patients, i.e. 71.2%). Only the mother of Patient 2 was administered digoxin before childbirth. The atrial rate of the tachyarrhythmia revealed a mean of 375 bpm, with an increase of up to 500 bpm. Atrioventricular conduction presented a 2:1 ratio in all patients, with variations of 3:1 and 4:1 observed in Patients 1, 3 and 6. The ventricular rate ranged from 188 to 250 bpm. All patients revealed typical and counter-clockwise electrocardiogram characteristics. Synchronized electrical cardioversion was the treatment of choice in 6 patients (85.7%), with a dose of 1 J/kg. Conclusion: Early diagnosis, prior treatment, and synchronized electrical cardioversion indicate an excellent prognosis, and prolonged maintenance treatment may be unnecessary.

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Réduction d’un flutter atrial néonatal récidivant par chocs de cardioversion et amiodarone

Cited by 4 publications

References 5 publications

Neonatal Atrial Flutter: Case Report

Neonatal Atrial Flutter: Case Report

Abordagem de Flutter Atrial Neonatal: Uma Série de Casos

Neonatal Atrial Flutter Approach: A Case Series

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