| Popis: |
多源性心房頻拍(multifocal atrial tachycardia, MAT)は心房における複数起源とする自動能の異常亢進により生じる稀な不整脈である。多くは無治療のまま自然消退するが、治療抵抗性である症例も散見される。我々は治療抵抗性のMATの新生児例を経験した。胎児期より胎児水腫を指摘されていた。日齢3より頻脈性不整脈が出現し、複数の抗不整脈薬を投与したが再燃を繰り返していた。日齢22にMATと診断後フレカイニドの投与を行い洞調律化に成功した。その後フレカイニドとランジオロールの二剤のみで洞調律を維持した。(著者抄録)Multifocal atrial tachycardia (MAT) is an uncommon arrhythmia caused by irregular atrial rhythm from multiple ectopic foci within the cardiac atrium or from a single ectopic focus with different exit pathways or abnormal intra- atrial conduction. The majority of MAT are self-limited and non-sustained, but some become symptomatic which then are usually resistant to therapy. We report here a male newborn with symptomatic MAT not responding to several anti-arrhythmic medications. He was prenatally diagnosed with fetal hydrops. At his 3rd day of life (DOL), he developed a supraventricular tachycardia not responding to several antiarrhythmic medications. At his 22nd DOL, his supraventricular tachycardia was diagnosed as MAT and was controlled by intravenous flecainide. Other antiarrhythmic medications administered were discontinued and only flecainide and landiolol hydrochloride were continued. |
