What causes pediatric atrial flutter?

Updated: Feb 04, 2019
  • Author: M Silvana Horenstein, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Atrial flutter may comprise up to one third of all fetal tachyarrhythmias. [4] Most fetuses and neonates with atrial flutter have structurally normal hearts. However, when atrial flutter is detected in a fetus, structural cardiac anomalies such as Ebstein anomaly of the tricuspid valve and atrioventricular (AV) septal defects should be ruled out because of a higher incidence of such defects in these cases.

Some newborns and young children have associated conditions or anomalies that may predispose them to atrial flutter. Atrial septal aneurysms appear to be associated with sustained atrial arrhythmias in newborns, but this association is not as high as is seen in adult subjects. Restrictive cardiomyopathies are also associated with refractory atrial flutter. In Costello syndrome, the dysmorphic appearance is also associated with a dysrhythmia characterized as chaotic atrial tachycardia, and this dysrhythmia may include long episodes of atrial flutter.

Atrial flutter is not uncommon in the immediate postoperative period after congenital heart surgery. Surgery-induced inflammation of the pericardium, scarring, and volume overload may trigger atrial flutter.

Case reports have linked atrial flutter to ingestion of herbal medicines and certain foods. These episodes did not recur after avoidance of the triggers.

Atrial flutter and atrial fibrillation have been related to obesity, alcohol consumption, and hyperthyroidism. [5, 6, 7] One study reported that in adults, diabetes mellitus is a strong independent risk factor for development of atrial flutter and atrial fibrillation. [8]

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