NEONATAL ATRIAL-FLUTTER - SIGNIFICANT EARLY MORBIDITY AND EXCELLENT LONG-TERM PROGNOSIS

Twenty-five neonates (16 boys and 9 girls) who had atrial flutter were identified. Diagnosis was made on or before the first day of life in 18 (72%). Heart failure were present in 9 patients, and hydrops fetali s was present in another 5. Atrial and ventricular rates did not diffe r between symptomatic and asymptomatic patients. Atrioventricular cond uction was variable in 16 patients, and documented 1:1 conduction occu rred in 5. Digoxin was the initial drug therapy given to 21 patients, with 7 reverting to sinus rhythm. Electrical cardioversion (pacing or synchronized shock) was attempted in 13 of the 14 cases in which digox in was not successful and was attempted as the first treatment in 3 ca ses. Sustained sinus rhythm was achieved in 9. Two infants died of com plications from prematurity but without having been successfully conve rted to sinus rhythm. No patient had atrial flutter during long-term f ollow-up (median 23 months). Neonatal atrial flutter has significant m orbidity but an excellent longterm prognosis.