Pharmacological Cardioversion by Intravenous Amiodarone for Primary Treatment of a Neonatal Atrial Flutter

Atrial flutter is an uncommon arrhythmia in newborn patients, but it can be fatal in intractable cases, which require emergent therapy with multiple antiarrhythmic therapies and an electrical cardioversion. Amiodarone is an antiarrhythmic drug commonly used to treat tachyarrhythmias of supraventricular tachycardia and atrial tachyarrhythmia in adults. The efficacy of amiodarone therapy for neonatal tachyarrhythmia including atrial flutter is currently unknown, but its estimated effectiveness is low with small experiences in neonates. We present a case of successful pharmacologic cardioversion, using intravenous amiodarone, of atrial flutter and did not require electrical cardioversion in a newborn. We suggest that intravenous amiodarone administration can be used to treat neonatal atrial flutter as effective pharmacological therapy in patient with hemodynamic stability.