NDLI: Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report

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Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report

Content Provider	MDPI
Author	Belli, Gilda Giovannini, Mattia Porcedda, Giulio Moroni, Marco Marca, Giancarlo La Capponi, Guglielmo Favilli, Silvia Simone, Luciano De
Copyright Year	2020
Description	Supraventricular tachyarrhythmia (SVT) is the most common type of arrhythmia in childhood. Management can be challenging with an associated risk of mortality. A female neonate was diagnosed with episodes of SVT, controlled antenatally with digoxin. Flecainide was commenced prophylactically at birth. Despite treatment, the infant developed a narrow complex tachycardia at 5 days of age. The electrocardiogram features were suggestive of either re-entry tachycardia or of automatic atrial tachycardia (AAT). Following several unsuccessful treatments, a wide complex tachycardia developed. A transesophageal electrophysiological study led to a diagnosis of AAT. Stable sinus rhythm was finally achieved through increasing daily administrations of flecainide up to six times a day, in association with nadolol. The shortening of intervals to this extent has never been reported before and supports the evidence of a personal, age-specific variability in pharmacokinetics of flecainide. Larger studies are needed to better define the appropriate dose and timing of administration.
Ending Page	113
Page Count	6
Starting Page	108
e-ISSN	20367503
DOI	10.3390/pediatric12030024
Journal	Pediatric reports
Issue Number	3
Volume Number	12
Language	English
Publisher	MDPI
Publisher Date	2020-11-11
Access Restriction	Open
Subject Keyword	Pediatric reports Pediatric Reports Pediatrics and Child Health Supraventricular Tachyarrhythmia Automatic Atrial Tachycardia Flecainide Pharmacokinetics Newborn
Content Type	Text
Resource Type	Article

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