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Open AccessCase Report

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

1
Department of Health Sciences, Post-graduate School of Pediatrics, Meyer Children’s University Hospital, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy
2
Department of Pediatric Cardiology, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
3
Neonatal Intensive Care Unit-Medical Surgical Fetal-Neonatal Department, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
4
Department of Experimental and Clinical Biomedical Sciences, Meyer Children’s University Hospital, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy
*
Author to whom correspondence should be addressed.
Pediatr. Rep. 2020, 12(3), 108-113; https://doi.org/10.3390/pediatric12030024
Received: 21 January 2020 / Accepted: 28 February 2020 / Published: 11 November 2020
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. View Full-Text
Keywords: supraventricular tachyarrhythmia; automatic atrial tachycardia; flecainide; pharmacokinetics; newborn supraventricular tachyarrhythmia; automatic atrial tachycardia; flecainide; pharmacokinetics; newborn
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MDPI and ACS Style

Belli, G.; Giovannini, M.; Porcedda, G.; Moroni, M.; la Marca, G.; Capponi, G.; Favilli, S.; De Simone, L. Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report. Pediatr. Rep. 2020, 12, 108-113. https://doi.org/10.3390/pediatric12030024

AMA Style

Belli G, Giovannini M, Porcedda G, Moroni M, la Marca G, Capponi G, Favilli S, De Simone L. Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report. Pediatric Reports. 2020; 12(3):108-113. https://doi.org/10.3390/pediatric12030024

Chicago/Turabian Style

Belli, Gilda; Giovannini, Mattia; Porcedda, Giulio; Moroni, Marco; la Marca, Giancarlo; Capponi, Guglielmo; Favilli, Silvia; De Simone, Luciano. 2020. "Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report" Pediatr. Rep. 12, no. 3: 108-113. https://doi.org/10.3390/pediatric12030024

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