Why the study?
Clinically significant arrhythmias in the fetal and early neonatal period are remarkably rare, and their medical management presents safety and efficacy dilemmas.
A stepwise approach including direct current cardioversion and oral propranolol can safely and effectively manage refractory neonatal atrial flutter/fibrillation.
DCC may rescue refractory neonatal atrial tachyarrhythmias after antiarrhythmic failure; leaves open need for prospective safety data.
In the fetal and early neonatal period, clinically significant arrhythmias are remarkably rare whose medical management has been an area of dilemma in terms of safety and efficacy. We present a case of a hemodynamically stable female neonate presenting to us with atrial tachycardia with morphology of atrial fibrillation (AF) and atrial flutter (AFl). After a poor response to multiple antiarrhythmics, direct current cardioversion (DCC) was the final solution. Short-term maintenance therapy with oral propranolol was given with no recurrence. Hence, stepwise approach to infants with AFl can lead to an excellent prognosis with a low risk of recurrence.
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Jain et al. (2021) studied this question.
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