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Electrical direct current cardioversion for the treatment of atrial flutter in extremely premature neonate
  1. Maduka Umeh1,2,
  2. Toriairma Klutse1,
  3. Justin Richards1,2,
  4. Anay Kulkarni1,2
  1. 1 Department of Neonatology, St George's Hospital NHS Foundation Trust, London, UK
  2. 2 Medical school, St George's, University of London, London, UK
  1. Correspondence to Dr Anay Kulkarni, Department of Neonatology, St George's Hospital NHS Trust, London SW17 0QT, UK ; kulkarni_anay{at}yahoo.co.uk

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Introduction

Atrial flutter is a type of supraventricular tachycardia (SVT), which is common in fetus and newborn caused by a re-entry mechanism in the atria. Electrical cardioversion is the first-line treatment for narrow complex tachycardia with circulatory compromise1; however, its use in extremely premature babies has not previously been reported. We share a case of an extremely preterm baby requiring electrical direct current (DC) cardioversion for spontaneous atrial flutter.

Case report

A 25+2 week preterm male baby with birth weight of 890 g with normal antenatal scans was born by spontaneous vaginal delivery. He was intubated for ventilatory support. Following admission to neonatal intensive care unit, at 1 hour of age, he suddenly became tachycardic with a heart rate of 246 beats per minute (bpm). ECG was consistent …

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