Prematüre Bir Yenidoğanda Kardiyoversiyon ile Tedavi Edilen Atriyal Flatter Olgusu

Abstract

Atrial flatter yenidoğan ve bebeklerde nadir görülen bir aritmidir. Anne karnında, perinatal dönemde ve bebeklik süresince ortaya çıkabilir. Atriyal flatter, yenidoğanlarda sıklıkla asemptomatiktir. Atriyal flatterli yenidoğan hastaların % 20’si kalp yetmezliği tablosunda başvururken, hastaların çoğu asemptomatik taşikardi ile başvurmaktadırlar. Hastaları sinüs ritmine döndürmek için ilaç tedavisi, senkronize kardiyoversiyon, kalp pili gibi tedavi yöntemleri kullanılmaktadır. Çoğu olgu dijitalizasyon veya elektriksel kardiyoversiyon ile kolaylıkla sinüs ritmine döndürülebilir. Elektriksel kardiyoversiyon yenidoğanlardaki persistan atrial flatter için iyi bir tedavi yöntemidir. Elektriksel kardiyoversiyona cevap veren atriyal flatterli bir yenidoğan olgusunu sunduk.

Keywords

• Atriyal flatter, Kardiyoversiyon, Yenidoğan

A Case of Atrial Flutter Treated by Cardioversion in a Premature Newborn

Abstract

Atrial flutter is an uncommon arrhythmia in newborns and infants. It may manifest in the intrauterine, perinatal periods or during infancy. Newborns with atrial flutter are frequently asymptomatic, and in most patients it begins as asymptomatic tachycardia, although in up to 20% it may present with heart failure. Drugs, synchronized cardioversion or pacemakers are used for the conversion to sinus rhythm in these patients. In most cases, it is easily converted to sinus rhythm by electrical cardioversion or digitalization. Electrical cardioversion is a good treatment modality for neonates with sustained atrial flutter. We have presented a neonate with atrial flutter who responded to electrical cardioversion

Keywords

• Atrial flutter, Cardioversion, Neonate

References

1. Texter KM, Kertesz NJ, Friedman RA, Fenrich AL. Atrial flutter in infants. J Am Coll Cardiol 2006;48:1040-6.
2. Casey FA, McCrindle BW, Hamilton RM, Gow RM. Neonatal atrial flutter: Significant early morbidity and excellent long-term prognosis. Am Heart J 1997;133:302-6.
3. Suzumura H, Nitta A, Ono M, Arisaka O. Neonatal intractable atrial flutter successfully treated with intravenous flecainide. Pediatr Cardiol 2004;25:154-6.
4. Paç A, Çeliker A, Bilgiç A. Yenidoğanda kardiyoversiyon ile tedavi edilen atriyal flatter olgusu. Türkiye Klinikleri J Cardiology 1993;6:169-71.
5. Lown B, Amarasingham R, Neuman J. New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA 1962;182:548-55.
6. Hassenrueck A, Chojnacki B, Barker HJ. Cardioversion of auricular flutter in a newborn infant. Am J Cardiol 1965;15:726-31.
7. Knirsch W, Kretschmar O, Vogel M, Uhlemann F, Bauersfeld U. Successful treatment of atrial flutter with amiodarone in a premature neonate: Case report and literature review. Advances in Neonatal Care 2007;7:113-21.
8. Lisowski LA, Verheijen PM, Benatar AA, Soyeur DJ, Stoutenbeek P, Brenner JI, et al. Atrial flutter in the perinatal age group: Diagnosis, management and outcome. J Am Coll Cardiol 2000;35:771-7.

9. Garson A Jr, Bink-Boelkens M, Hesslein PS, Hordof AJ, Keane JF, Neches WH, et al. Atrial flutter in the young: A collaborative study of 380 cases. J Am Coll Cardiol 1985;6:871-8.
10. Ceresnak SR, Starc TJ, Hordof AJ, Pass RH, Bonney WJ, Liberman L. Elevated impedance during cardioversion in neonates with atrial flutter. Pediatr Cardiol 2009; 30:436-40.