Clinical characteristics and outcomes of atrial flutter in neonates.

BACKGROUND: Atrial flutter is an uncommon arrhythmia that can cause severe morbidity, including heart failure and even death in refractory cases. This study investigated the clinical characteristics, treatment, and long-term outcomes of patients with neonatal atrial flutter and its association with heart failure. METHODS: We retrospectively reviewed atrial flutter cases observed in our center between 1999 and 2021 and analyzed the clinical characteristics, treatment, and recurrence according to the presence of heart failure. RESULTS: The study comprised 15 patients with atrial flutter, with median bodyweight and gestational age of 2.7 kg, 37+4 weeks, respectively. Twelve patients were diagnosed with atrial flutter on the first day of life. The median atrial and ventricular rates were 440/min, 220/min, respectively. Four patients exhibited congestive heart failure. Episodic recurrence was noted in five patients and occurred at a higher rate in patients with congestive heart failure (p = 0.004). Antiarrhythmic drugs for maintenance treatment were administered more often in patients with heart failure (p = 0.011). Initial treatment included direct current cardioversion (n = 9), digoxin (n = 4), and observation (n = 2). Four patients treated with cardioversion experienced recurrence during the neonatal period, and none of those treated with digoxin experienced recurrence. The median follow-up duration was 7 years, during which no atrial flutter recurrence was evident. CONCLUSION: Neonates with congestive heart failure had a higher recurrence of atrial flutter. Direct current cardioversion is the most reliable treatment for neonatal atrial flutter, whereas digoxin may be a viable treatment option in refractory and recurrent cases.

Relationship between Personal Values and Intentions to Purchase Plant-Based Meat Alternatives: Application of the Dual Concern Theory.

This study examines consumers' intentions to purchase plant-based meat alternatives (PBMA), which have been created to protect animal rights, the global environment, and consumers' health. Data from 319 Korean consumers were analyzed to establish a causal relationship among personal values (egoistic, biospheric, and social-altruistic), the dual concern theory (anticipated positive effect and empathetic concern), and PBMA purchase intentions. Multigroup analysis was performed for all paths according to generation, divided into Generation MZ and the older generation; "MZ" is a compound term referring to millennials and Generation Z, who have grown up in a digital environment; this collective generation comprises individuals born after 1980. Our analysis revealed that, among personal values, biospheric and social-altruistic values had positive effects on both anticipated positive effect and empathetic concern. In turn, these aspects positively influenced PBMA purchase intentions. Particularly, anticipated positive effect had a strong influence. Finally, a moderating effect was confirmed for two paths, and only Generation MZ demonstrated the enhancing influence of biospheric value on both anticipated positive effect and empathetic concern. This study has several implications and contributes to the sustainable growth and development of PBMA and the overall food service industry.