Digoxin is an effective and preferred initial therapy for non-acutely ill infants with idiopathic atrial flutter, whereas DC cardioversion is necessary for those with cardiac decompensation.
Answers are grounded in this paper and cite their sources.
May favor digoxin for neonatal atrial flutter; leaves open comparative efficacy versus cardioversion in older infants.
The experience of three institutions in the management of atrial flutter in infants under 2 years of age without associated heart disease is reviewed. Five babies with neonatal onset were treated with digoxin and had uncomplicated resolution of their arrhythmia, although one continued to have episodes of paroxysmal supraventricular tachycardia for six years. Two of the three older infants required DC cardioversion for complications after quinidine was substituted for digoxin therapy. Digoxin continues to be the preferred initial therapy for non-acutely ill patients; those showing signs of cardiac decompensation should be converted with DC countershock.
No takes yet. Share an insight, caveat, or question.
Rowland et al. (1978) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: