Flutter atriale neonatale isolato: Clinica, prognosi e terapia

Translated title of the contribution: Isolated neonatal atrial flutter: Clinical features, prognosis and therapy

Fabrizio Drago, Andrea Mazza, Salvatore Garibaldi, Antonella Mafrici, Antonella Santilli, Pietro Ragonese

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Concern exists in literature about the clinical course, the best acute and chronic treatment and the prognosis of idiopathic neonatal atrial flutter. The aim of our study was to evaluate this in a population of our patients with this type of arrhythmia. METHODS. Six infants (3 M, 3 F, mean age 42 ± 62 days, range 1-150) affected with atrial flutter without structural heart disease were studied and then acutely and chronically treated. The effectiveness of chronic antiarrhythmic treatment was evaluated with Holter monitoring every 3 months for the first year of life and with transesophageal atrial pacing. RESULTS. Mean arrhythmia cycle length was 180 ± 34 ms with atrioventricular conduction ratio ranging between 1:1 and 3:1. Two patients with clinical signs of heart failure were successfully treated with DC shock. Transesophageal overdrive atrial pacing was successfully used in one patient treated with iv propafenone without benefit. In the remaining three patients, cardioversion was achieved with amiodarone after digoxin had failed in all three and propafenone had failed in two of them. To prevent recurrences, we treated four patients with amiodarone, one with amiodarone combined with propranolol and one with digoxin. During the follow-up (22 ± 11 months), neither arrhythmia recurrences nor side-effects of the therapy occurred. CONCLUSIONS. Neonatal atrial flutter is an arrhythmia with significant acute morbidity but an excellent long-term prognosis. Electrical cardioversion is the first-choice treatment when the arrhythmia is not well- tolerated hemodynamically, while class III antiarrhythmic drugs such as amiodarone should be preferred in the other cases.

Translated title of the contributionIsolated neonatal atrial flutter: Clinical features, prognosis and therapy
Original languageItalian
Pages (from-to)365-368
Number of pages4
JournalGiornale Italiano di Cardiologia
Volume28
Issue number4
Publication statusPublished - Apr 1998

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Drago, F., Mazza, A., Garibaldi, S., Mafrici, A., Santilli, A., & Ragonese, P. (1998). Flutter atriale neonatale isolato: Clinica, prognosi e terapia. Giornale Italiano di Cardiologia, 28(4), 365-368.