Management of multifocal atrial tachycardia in a newborn baby by flecainide

Abstract

 Multifocal atrial tachycardia (MAT) is an uncommon arrhythmia caused by irregular atrial rhythm from multiple ectopic foci within the cardiac atrium or from a single ectopic focus with different exit pathways or abnormal intra- atrial conduction. The majority of MAT are self-limited and non-sustained, but some become symptomatic which then are usually resistant to therapy. We report here a male newborn with symptomatic MAT not responding to several anti-arrhythmic medications. He was prenatally diagnosed with fetal hydrops. At his 3^rd day of life (DOL), he developed a supraventricular tachycardia not responding to several antiarrhythmic medications. At his 22^nd DOL, his supraventricular tachycardia was diagnosed as MAT and was controlled by intravenous flecainide. Other antiarrhythmic medications administered were discontinued and only flecainide and landiolol hydrochloride were continued.