A flutter ekg8/29/2023 ![]() ![]() Due to respiratory distress syndrome, nasal Duo positive airway pressure was performed for the first two days of postnatal life. The preterm boy had birth weight 2600 g and had head circumference and length in normal values range of 50–90 centiles. Therefore, it is essential to know how to treat it. Atrial Flutter (AFL) is a rare but potentially lethal arrhythmia. However, because of an accompanying atrioventricular block, the ventricular rhythm is usually slower than the atrial rhythm. 1:1 atrioventricular conduction concerns the patients with a coexisting accessory pathway as it predisposes to ventricular fibrillation. Clinical features depend on the frequency of the ventricular rate. The newborns’ ECG tracing shows an atrial flutter wave (so-called “sawtooth”), which is seen in leads II, III, aVF, V1. Perinatal atrial flutter is approximately 9% mortality. ![]() Then the atrial flutter may result in circulatory failure, and in a more severe form, it may lead to a non-immune fetal hydrops. It is worth to mention that this type of atrial flutter is atypical and it mostly depends on a cavotricuspid isthmus.Ītrial flutter may also develop in patients with normal heart anatomy, mainly in newborns or in fetuses. It is also often observed after the Fontan procedure and repair of tetralogy of Fallot. Atrial flutter may develop post-operatively especially, after the cardio-surgery performed within atria: interatrial transposition of the great arteries using the Mustard or Senning procedure. It mainly concerns children suffering from congenital heart defects such as: transposition of the great arteries, complex cyanotic heart defect, atrial septal defect, Ebstein’s anomaly, pulmonary stenosis, tricuspid valve diseases. This arrhythmia is caused by the re-entry circuits limited to the right atrium. Moreover, CTG monitoring is of limited use because it does not record fetal heart rhythms > 200/min and echocardiography at the reference center is practically the only method to monitor the condition of the fetus with abnormal rapid heart rhythm.Ītrial flutter (AFL) is a rare type of an arrhythmia encountered in children, in the ECG tracing it is marked by a fast, irregular atrial activity 280–500 beats per minute. ConclusionsĪs neonatal AFL might be resistant to conventional pharmacotherapy, one needs to remember about the possibility of electrical cardioversion in the pediatric cardiology referral center. Then cardioversion was performed and the rhythm converted to normal. Arrhythmia was resistant to the therapy of amiodaron. The administration of adenosine resulted in the obvious appearance of “sawtooth wave” typical for AFL. ECG has shown supraventricular tachycardia with narrow QRS. We report a case of a neonate who was born at 34 weeks of gestational age by C-section because of risk for birth asphyxia, based on abnormal CTG tracing, which had no characteristic rhythms for fetal decelerations. However, with early prenatal diagnosis and proper treatment, the majority of AFL cases show a good prognosis. AFL may result in circulatory failure, and in a more severe form, it may lead to a non-immune fetal hydrops. ![]() AFL is known to be a rare and also life-threatening rhythm disorder both at the fetus and neonatal period. In the ECG tracing, it is marked by a fast, irregular atrial activity of 280–500 beats per minute. Atrial flutter (AFL) is a supraventricular tachyarrhythmia. ![]()
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