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Atrial flutter in the perinatal age group: diagnosis, management and outcome

Lukas A. Lisowski, MD^*, Paul M. Verheijen, MD^*, Avraham A. Benatar, MD, AFACC, Daniel J. G. Soyeur, MD, Phillip Stoutenbeek, MD^*, Joel I. Brenner, MD, FACC, Charles S. Kleinman, MD, FACC and Erik J. Meijboom, MD, FACC^*

^* Department of Obstetrics and Pediatric Cardiology, University Medical Center, Utrecht, The Netherlands
Department of Pediatric Cardiology, University Hospital, Liege, Belgium
Department of Pediatric Cardiology, University of Maryland Medical Systems, Baltimore, Maryland, USA
Department of Obstetrics/Gynecology and Pediatric Cardiology, Yale University Hospital, New Haven, Connecticut, USA

View larger version (20K): [in a new window]   Figure 1 Allocation of fetal patients with atrial flutter into two study groups at time of recognition: hydropic and nonhydropic. Patients are further subdivided into treated and nontreated for each group. Assoc. HLH = associated hypoplastic left heart syndrome; Dig/Sot/Proc/Quin/Flec/Prop = digoxin/sotalol/procainamide/quinidine/flecainide/propaphenone. The bottom boxes describe the number of cases with atrial flutter at birth per number of infants born alive.

View larger version (20K): [in a new window]   Figure 2 Outcome for the entire study group and treatment strategy for neonates in atrial flutter after birth. DCC = direct current cardioversion; TVAOP = transvenous atrial overdrive pacing; Death = death due to a neurological cause.