Intravenous sotalol for conversion of atrial flutter in infants

Atrial flutter is an uncommon arrhythmia in the pediatric population but is well described in the perinatal period, in early infancy, and after cardiac surgery. It often occurs in the third trimester of pregnancy and in the early newborn period, usually within the first 2 days of life.1 In infants without congenital heart disease (CHD) or ventricular dysfunction, the recurrence risk is low once flutter has been converted to sinus rhythm.2 Strategies for medical cardioversion include digoxin, with perhaps a 33% conversion rate to sinus rhythm after loading.