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June 1966

Atrial Fibrillation in Endocardial Fibroelastosis: Successful Cardioversion With External Countershock

Author Affiliations

From the Section of Pediatric Cardiology, Department of Pediatrics, University of Tennessee, College of Medicine, Memphis.

Am J Dis Child. 1966;111(6):655-660. doi:10.1001/archpedi.1966.02090090127016

ALTHOUGH current evidence is somewhat contradictory, there is reason to believe that restoration of a normal sinus rhythm and the atrial transport function in patients with atrial fibrillation will shift the ventricular function curve to an area of improved performance.1 Atrial fibrillation, a common arrhythmia in adults, is encountered infrequently in infants and children. This probably reflects the relative rarity of mitral valvular disease during this period of life. Atrial fibrillation has been related to prolonged pressure or volume distention of the atria.2

The purpose of this report is to describe the clinical course of an infant with endocardial fibroelastosis with mitral insufficiency and mild aortic regurgitation demonstrated during life by left ventricular angiography and retrograde aortography, respectively. He developed atrial fibrillation approximately five weeks before death. Normal sinus rhythm was restored by synchronized direct current countershock, and the patient was given diphenylhydantoin (Dilantin) as an antiarrhythmic agent.

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