title: Successful treatment of atrial flutter with amiodarone in a premature neonate. Case report and literature review.
abstract: This case report describes a 30-week gestation neonate who presented at birth with hydrops fetalis due to atrial flutter. Digoxin and electric cardioversion were unsuccessful in maintaining a stable sinus rhythm. The infant continued with intractable atrial flutter and severe hemodynamic deterioration until intravenous loading of amiodarone achieved conversion to stable sinus rhythm. Amiodarone was continued for 45 days; there was no recurrence of atrial flutter. Of note, the infant developed severe chronic lung disease after mechanical ventilation for 28 days. A lung biopsy ruled out amiodarone-induced pulmonary toxicity. A table is provided reviewing the different forms of neonatal supraventricular tachycardias. Apart from the successful management of the tachycardia, the role of amiodarone as an effective antiarrhythmic agent and its potential side effects, such as pulmonary toxicity and transient hypothyroidism, are discussed.
authors.affiliation: Department of Pediatric Cardiology and Pediatric Intensive Care, Olgahospital, Stuttgart, Germany. walter.knirsch@kispi.unizh.ch
authors.forename: Walter
authors.initials: W
authors.lastname: Knirsch
authors.forename: Oliver
authors.initials: O
authors.lastname: Kretschmar
authors.forename: Martin
authors.initials: M
authors.lastname: Vogel
authors.forename: Frank
authors.initials: F
authors.lastname: Uhlemann
authors.forename: Urs
authors.initials: U
authors.lastname: Bauersfeld
mesh_terms: D000638:Amiodarone / Q000009:adverse effects / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001282:Atrial Flutter / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D013617:Tachycardia, Supraventricular / Q000188:drug therapy
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone