Casey F A, McCrindle B W, Hamilton R M, Gow R M
Department of Pediatrics, Hospital for Sick Children, Toronto, Canada.
Am Heart J. 1997 Mar;133(3):302-6. doi: 10.1016/s0002-8703(97)70224-2.
Twenty-five neonates (16 boys and 9 girls) who had atrial flutter were identified. Diagnosis was made on or before the first day of life in 18 (72%). Heart failure were present in 9 patients, and hydrops fetalis was present in another 5. Atrial and ventricular rates did not differ between symptomatic and asymptomatic patients. Atrioventricular conduction was variable in 16 patients, and documented 1:1 conduction occurred in 5. Digoxin was the initial drug therapy given to 21 patients, with 7 reverting to sinus rhythm. Electrical cardioversion (pacing or synchronized shock) was attempted in 13 of the 14 cases in which digoxin was not successful and was attempted as the first treatment in 3 cases. Sustained sinus rhythm was achieved in 9. Two infants died of complications from prematurity but without having been successfully converted to sinus rhythm. No patient had atrial flutter during long-term follow-up (median 23 months). Neonatal atrial flutter has significant morbidity but an excellent long-term prognosis.
共识别出25例患有心房扑动的新生儿（16例男婴，9例女婴）。18例（72%）在出生第一天或之前确诊。9例患者出现心力衰竭，另有5例出现胎儿水肿。有症状和无症状患者的心房率和心室率无差异。16例患者房室传导情况各异，5例记录到1:1传导。21例患者最初接受地高辛药物治疗，7例恢复窦性心律。14例地高辛治疗无效的患者中有13例尝试了电复律（起搏或同步电击），3例作为首次治疗尝试。9例实现了持续窦性心律。2例婴儿死于早产并发症，但未成功转为窦性心律。长期随访（中位时间23个月）期间无患者出现心房扑动。新生儿心房扑动有显著的发病率，但长期预后良好。
