What are the ACC/AHA/HRS guidelines on pediatric atrial flutter?

Updated: Feb 04, 2019
  • Author: M Silvana Horenstein, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Answer

No specific guidelines have been developed for the management of pediatric atrial flutter. The 2015 American College of Cardiology, American Heart Association, and the Heart Rhythm Society (ACC/AHA/HRS) joint guidelines for the management of supraventricular tachycardia note that although the guidelines are intended for adults (age ≥18 years) and offer no specific recommendations for pediatric patients, in some cases, the data from noninfant pediatric patients was reviewed and helped to apprise the guidelines. [20]

The guidelines state that pharmacologic therapy for pediatric atrial flutter is largely based on practice patterns owing to the lack of random controlled trials of antiarrhythmic medications in children. Amiodarone, sotalol, propafenone, or flecainide may be used in infants. In older children, beta-blockers are used most often as the initial therapy. Flecainide is not used as a first-line agent in children because of the rare occurrence of adverse events. Catheter ablation may be successfully performed in children of all ages, with success rates comparable to those reported in adults. [20]


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