Clinical characteristics and outcomes of atrial flutter in neonates.

Autor: Kim G; Department of Pediatrics, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Republic of Korea., Shin JH; Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea., Gang MH; Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea., Lee YW; Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea., Chang MY; Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea., Jang H; Department of Pediatrics, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Republic of Korea., Kil HR; Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
Jazyk: angličtina
Zdroj: Pediatrics international : official journal of the Japan Pediatric Society [Pediatr Int] 2023 Jan-Dec; Vol. 65 (1), pp. e15714.
DOI: 10.1111/ped.15714
Abstrakt: Background: Atrial flutter is an uncommon arrhythmia that can cause severe morbidity, including heart failure and even death in refractory cases. This study investigated the clinical characteristics, treatment, and long-term outcomes of patients with neonatal atrial flutter and its association with heart failure.
Methods: We retrospectively reviewed atrial flutter cases observed in our center between 1999 and 2021 and analyzed the clinical characteristics, treatment, and recurrence according to the presence of heart failure.
Results: The study comprised 15 patients with atrial flutter, with median bodyweight and gestational age of 2.7 kg, 37 +4 weeks, respectively. Twelve patients were diagnosed with atrial flutter on the first day of life. The median atrial and ventricular rates were 440/min, 220/min, respectively. Four patients exhibited congestive heart failure. Episodic recurrence was noted in five patients and occurred at a higher rate in patients with congestive heart failure (p = 0.004). Antiarrhythmic drugs for maintenance treatment were administered more often in patients with heart failure (p = 0.011). Initial treatment included direct current cardioversion (n = 9), digoxin (n = 4), and observation (n = 2). Four patients treated with cardioversion experienced recurrence during the neonatal period, and none of those treated with digoxin experienced recurrence. The median follow-up duration was 7 years, during which no atrial flutter recurrence was evident.
Conclusion: Neonates with congestive heart failure had a higher recurrence of atrial flutter. Direct current cardioversion is the most reliable treatment for neonatal atrial flutter, whereas digoxin may be a viable treatment option in refractory and recurrent cases.
(© 2023 Japan Pediatric Society.)
Databáze: MEDLINE
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