(A) 12-lead ECG demonstrating atrial flutter with variable conduction in a 10-day-old infant who presented to the emergency department with poor feeding.

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(A) 12-lead ECG demonstrating atrial flutter with variable conduction in a 10-day-old infant who presented to the emergency department with poor feeding and irritability. The flutter rate is more than 300. (B) A dose of adenosine is very helpful to differentiate atrial flutter from supraventricular tachycardia (SVT). Adenosine reversibly blocks the AV node; hence, there will be no AV conduction. As seen in this patient, when adenosine is given, the flutter waves are not conducted, thus confirming the diagnosis. Adenosine only aids to confirm the diagnosis of atrial flutter but it would not terminate the flutter. Adenosine could terminate SVT. (Photo contributor: Shyam Sathanandam, MD.) Source: Chapter 5. Cardiology, Atlas of Pediatric Emergency Medicine, 2e Citation: Shah BR, Lucchesi M, Amodio J, Silverberg M. Atlas of Pediatric Emergency Medicine, 2e; 2013 Available at: http://accesspediatrics.mhmedical.com/DownloadImage.aspx?image=/data/books/shah2/shah2_c005f022b.png&sec=42533308&BookID=577&ChapterSecID=42532491&imagename= Accessed: November 07, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved