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Idiopathic Neonatal Atrial Flutter


Presentation

  • Completed images are prepared for any media: print, web and screen presentations.[interfacemarketinggroup.com]
  • This condition may present in utero as persistent bradycardia with postnatal ECG showing a very short QT interval. 2014 S.[karger.com]
  • Presentation Bradycardia may be asymptomatic but can present with syncope, fatigue or dizziness.[patient.info]
  • Usually neonates and infants with arrhythmias present with congestive hearth failure due to tachycardiomyopathies.[af-ablation.org]
  • Improve your interpretation of presenting symptoms with 38 new topics and 40 new images in the Differential Diagnosis section, and optimize patient care with more than 250 new figures and tables.[books.google.ro]
Physician
  • *Medscape Business of Medicine Academy Survey, September 2015 Learn from Experienced Professionals Courses were developed especially for physicians by business health experts and experienced physicians.[medscape.org]
  • […] coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse practitioners, and physician[books.google.ro]
  • Information Pediatrics Performance Improvement Performance Measures Perioperative Care and Consultation Pharmacoeconomics Pharmacoepidemiology Pharmacogenetics Pharmacy and Clinical Pharmacology Physical Medicine and Rehabilitation Physical Therapy Physician[jamanetwork.com]
  • EFE had quickly become the name of a disease, and it continues to be used by many physicians in this way, though many patients with identical symptoms do not have the endocardial reaction of EFE.[en.wikipedia.org]
  • Atrial Fibrillation/Atrial Flutter: What every physician needs to know. Atrial fibrillation (AF) is the most common arrhythmia requiring therapy and is associated with significant morbidity and mortality.[thecardiologyadvisor.com]
Asymptomatic
  • AFL may manifest as asymptomatic tachycardia, congestive heart failure or hydrops. [from ORDO ] Etiology Pacing Clin Electrophysiol 2016 Aug;39(8):792-6. Epub 2016 Jun 7 doi: 10.1111/pace.12888.[ncbi.nlm.nih.gov]
  • To date, the patient has remained asymptomatic.[revespcardiol.org]
  • Our extensive experience among children with tachyarrhythmias has substantially contributed to the scientific literature progress in order to revisit current guidelines particulary in asymptomatic children with ventricular preexcitation.[af-ablation.org]
  • Asymptomatic AF is common even in symptomatic patients, irrespective of whether the initial presentation was persistent or paroxysmal. B.[thecardiologyadvisor.com]
  • Presentation Bradycardia may be asymptomatic but can present with syncope, fatigue or dizziness.[patient.info]
Congestive Heart Failure
  • AFL may manifest as asymptomatic tachycardia, congestive heart failure or hydrops. [from ORDO ] Etiology Pacing Clin Electrophysiol 2016 Aug;39(8):792-6. Epub 2016 Jun 7 doi: 10.1111/pace.12888.[ncbi.nlm.nih.gov]
  • It is important to rule out treatable conditions that can result in AF including hyperthyroidism, pericarditis, anemia, and congestive heart failure.[thecardiologyadvisor.com]
  • heart failure, coronary artery disease, dilated cardiomyopathy, holiday heart syndrome, hypertensive heart disease, hypertrophic cardiomyopathy, ischemic heart disease, Lown-Ganong-Levine syndrome, mitral regurgitation, mitral valve prolapse, mitral[wikidoc.org]
  • Ischaemic chest pain, Stokes-Adams attacks, hypoxic seizures, congestive heart failure, cardiovascular collapse and sudden cardiac death may occur, depending on the underlying cause of bradycardia. [ 2 ] History Establish whether there is any history[patient.info]
Recurrent Respiratory Infections
  • Prakash Billakanti Babu View full Text pdf A case of recurrent respiratory infection in a child due to undiagnosed foreign body.[ijrrms.com]
Amyloidosis
  • Fibroelastosis is strongly seen as a primary cause of restrictive cardiomyopathy in children, along with cardiac amyloidosis, which is more commonly seen in progressive multiple myeloma patients and the elderly. [ citation needed ] Cause [ edit ] A review[en.wikipedia.org]
Tachycardia
  • Idiopathic neonatal atrial flutter (AFL) is a rare rhythm disorder, characterized by sustained tachycardia in newborns and infants with an atrial rate often at around 440 beats/minute (range 340-580).[ncbi.nlm.nih.gov]
  • Permanent Junctional Reciprocating Tachycardia. Atriofascicular Re-Entry Tachycardia. Atrioventricular Nodal Re-Entry Tachycardia. Junctional Ectopic Tachycardia. Ventricular Tachycardia. Neonatal Ventricular Tachycardia.[terkko.helsinki.fi]
  • […] ventricular tachycardia Ventricular tachycardia, monomorphic Ventricular tachycardia, nonsustained Ventricular tachycardia, paroxysmal Ventricular tachycardia, polymorphic Ventricular tachycardia, sustained Clinical Information A cardiac rhythm characterized[icd10data.com]
  • The PR interval may also prolong. 5 Figure 21-1 shows a comparison of sinus tachycardia and atrial tachycardia. FIGURE 21-1 A, Sinus tachycardia vs B, ectopic atrial tachycardia (EAT).[accesspediatrics.mhmedical.com]
  • This sequence occurs following permanent junctional reciprocating tachycardia, incessant atrial ectopic tachycardia and ventricular tachycardia. Palpitations and/or syncope are the first clinical manifestation in older children.[af-ablation.org]
Cyanosis
  • Examination Note whether the patient looks well or there are signs of inadequate cardiac output - for example, cold peripheries, peripheral cyanosis or features of congestive cardiac failure.[patient.info]
Hydrops Fetalis
  • Synonyms: Idiopathic hydrops fetalis Hydrops fetalis nonimmune Familial non-immune hydrops fetalis Frequency: The best estimate for how common hydrops fetalis is in the United States is approximately 1 in 600 to 1 in 4000 pregnancies.[lymphedemapeople.com]
  • fetalis Iatrogenic Cardiac surgery, cardiac transplantation, heart bypass surgery, incomplete ablation procedures, open heart surgery, temporary cardiac pacing Infectious Disease Amoebiasis, neonatal coxsackie myocarditis, rheumatic fever Musculoskeletal[wikidoc.org]
Stroke
  • Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. ‎ Seite 140 - Wang Q, Shen J, Splawski I et al.[books.google.de]
  • Atrial flutter (AFL) is less common than AF but more difficult to control with drugs and is also associated with an increased risk of stroke. In some patients these arrhythmias may be asymptomatic but still result in heart failure or stroke.[thecardiologyadvisor.com]
  • This arrhythmia accounts for about one-third of all strokes, and 30% of all patients with atrial fibrillation have a family history of the disease.[nature.com]
  • Take advantage of a wealth of images that capture the clinical manifestations and findings associated with Kawasaki disease, lupus, lymphoma, stroke, and many other disorders seen in children.[books.google.ro]
  • As with adults, the risk of stroke or pulmonary embolism is increased if your child has been diagnosed with this condition.[heart.org]

Workup

Sinus Arrhythmia
  • An athlete may show sinus arrhythmia but this is rare beyond 30. Note any shift in the cardiac apex. Aetiology Sinus bradycardia may be physiological with a high resting vagal tone - eg, in athletes or the diving reflex.[patient.info]

Treatment

  • If the arrhythmia persists after correction of all factors, treatment should be provided.[escardio.org]
  • BACKGROUND: Concern exists in literature about the clinical course, the best acute and chronic treatment and the prognosis of idiopathic neonatal atrial flutter.[ncbi.nlm.nih.gov]
  • In other cases, medical treatment is needed to restore a normal heart rhythm. Rarely, the arrhythmia does not return to normal with medical treatment and the person remains in chronic atrial fibrillation.[mottchildren.org]
  • Treatment (for a newborn): Treatment may involve direct transfuions of packed red blood cells, small needle aspiration to remove any excess fluid from around the lung or abdomen.[lymphedemapeople.com]
  • Antiarrhythmic Drug Treatment. Pacemakers and Implantable Defibrillators. Catheter Ablation. Artifacts. Appendix.[terkko.helsinki.fi]

Prognosis

  • PMID: 263874 Prognosis Drago F, Mazza A, Garibaldi S, Mafrici A, Santilli A, Ragonese P G Ital Cardiol 1998 Apr;28(4):365-8. PMID: 9616850 Rutledge J, Robertson MA, Kantoch M, Dyck J Can J Cardiol 1997 Sep;13(9):855-7. PMID: 9343037[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Neonatal atrial flutter is an arrhythmia with significant acute morbidity but an excellent long-term prognosis.[ncbi.nlm.nih.gov]
  • Prognosis: 50% of all cases diagnoses in utero result in fetal death 50% of all live born infants with nonimmune hydrops die Exact prognosis depends on the underlying condition idiopathic - 20-25% survive the newborn period anemia that can be treated[lymphedemapeople.com]
  • Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow.[books.google.ro]
  • Brand FN, Abbott RD, Kannel WB, Wolf PA (1985) Characteristics and prognosis of lone atrial fibrillation. JAMA 254(24): 3449–3453 PubMed Google Scholar 3. Caralis DG, Varese PJ (1976) Familial sinoatrial node dysfunction.[link.springer.com]

Etiology

  • [from ORDO ] Etiology Pacing Clin Electrophysiol 2016 Aug;39(8):792-6. Epub 2016 Jun 7 doi: 10.1111/pace.12888. PMID: 27196949 Till J, Wren C Br Heart J 1992 Jan;67(1):80-3. doi: 10.1136/hrt.67.1.80.[ncbi.nlm.nih.gov]
  • Tiwari S, Sahu M View full Text pdf Etiological spectrum and complications of acute diarrhoeal diseases in adults.[ijrrms.com]
  • Black-Schaffer B. (1957) "Infantile endocardial fibroelastosis: a suggested etiology", AMA Archives of Pathology 63: :281-306.[en.wikipedia.org]
  • This arrhythmia may be either of congenital etiology or may occur after cardiac surgery. Sudden death is uncommon in children with arrhythmias but when it occurs, is frequently caused by ventricular arrhythmias.[af-ablation.org]
  • Causes: Nonimmune-related hydrops fetalis (NIHF) can result from primary myocardial failure, high-output cardiac failure, decreased colloid oncotic plasma pressure, increased capillary permeability, or obstruction of venous or lymphatic flow, among other etiologies[lymphedemapeople.com]

Epidemiology

  • Anatomy, Physiology, and Epidemiology of Arrhythmias. ECGs and Other Recording Devices. Other Diagnostic Techniques. The Normal ECG and Variants. Interpretation of the ECG in Tachycardia. Adenosine in the Diagnosis of Tachycardias.[terkko.helsinki.fi]
  • Epidemiology It is impossible to give meaningful figures on incidence and prevalence. In most young people bradycardia is physiological and represents athletic training.[patient.info]
  • Epidemiology of heart disease and pregnancy. In: Zipes D, Rowlands D, eds. Progress in Cardiology. Philadelphia: Lea & Febiger, 1992. 3. Szekely P, Snaith L. Atrial fibrillation and pregnancy. Br Med J 1961;5237:1407–10. 4. Wellens HJ, Conover MB.[escardio.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow.[books.google.ro]
  • This review describes the pathophysiology and corresponding electrocardiographic findings of each arrhythmia. In addition, this summary compares the clinical findings, management, and outcomes of these arrhythmias during fetal and postnatal life.[hw-f5-neoreviews.highwire.org]
  • About a pathophysiological interpretation of the AF occurrence in our baby, it can be hypothesized that the mechanical irritation of both atria caused by the malposition of the CVC might be the underling mechanism responsible for the triggering of this[academic.oup.com]
  • Despite our incomplete understating of the pathophysiology of AF, treatment has improved over the last decade due to recent advances in catheter ablation, new antiarrhythmic drugs, pacing, and anticoagulation.[thecardiologyadvisor.com]

Prevention

  • Seite 182 - Antithrombotic Trialists' Collaboration: Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction and stroke in high risk patients. ‎[books.google.de]
  • It aims to reduce delays in recognising and treating sick babies and prevent unnecessary use of antibiotics.[nice.org.uk]
  • Hospital for Sick Children Health A-Z Search a complete list of child health articles expand_more View All Drug A-Z Search a list of articles about medications expand_more View All Learning Hubs Browse a complete list of content groups Healthy Living & Prevention[aboutkidshealth.ca]
  • Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse[books.google.ro]

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