TY - JOUR
T1 - Fetal supraventricular tachycardia diagnosed and treated at twenty-four weeks of gestation and after birth
T2 - A case report
AU - Romeo, Emanuele
AU - D'Alto, Michele
AU - Russo, Maria Giovanna
AU - Sarubbi, Berardo
AU - Cardaropoli, Dominga
AU - Paladini, Dario
AU - Pacileo, Giuseppe
AU - Annunziata, Annalisa
AU - Calabrò, Raffaele
PY - 2004/10
Y1 - 2004/10
N2 - Supraventricular tachycardia is the most common clinically significant fetal tachycardia. The diagnosis is usually made at routine sonographic workup during the second-third trimester of pregnancy. Treatment goals are cardioversion to sinus rhythm and reversal of cardiac dysfunction. We describe a case of fetal supraventricular tachycardia diagnosed at 24 weeks of gestation. The first-line treatment was oral maternal digoxin and sotalol. This therapy was not sufficient for complete control of the tachycardia. Hence, second-line treatment with digoxin and flecainide was started and successfully achieved conversion to sinus rhythm. No adverse maternal side effects were noted during the 14 weeks of therapy. A normal male infant was delivered at elective cesarean section performed for obstetric indications at 38 weeks of gestation. A persistent junctional reciprocating tachycardia with a ventriculo-atrial/ atrioventricular ratio > 1 was diagnosed following delivery at transesophageal electrophysiological study. At the age of 8 months the child is on therapy with sotalol (4 mg/kg/day) and flecainide (3 mg/kg/ day) and is in good clinical conditions.
AB - Supraventricular tachycardia is the most common clinically significant fetal tachycardia. The diagnosis is usually made at routine sonographic workup during the second-third trimester of pregnancy. Treatment goals are cardioversion to sinus rhythm and reversal of cardiac dysfunction. We describe a case of fetal supraventricular tachycardia diagnosed at 24 weeks of gestation. The first-line treatment was oral maternal digoxin and sotalol. This therapy was not sufficient for complete control of the tachycardia. Hence, second-line treatment with digoxin and flecainide was started and successfully achieved conversion to sinus rhythm. No adverse maternal side effects were noted during the 14 weeks of therapy. A normal male infant was delivered at elective cesarean section performed for obstetric indications at 38 weeks of gestation. A persistent junctional reciprocating tachycardia with a ventriculo-atrial/ atrioventricular ratio > 1 was diagnosed following delivery at transesophageal electrophysiological study. At the age of 8 months the child is on therapy with sotalol (4 mg/kg/day) and flecainide (3 mg/kg/ day) and is in good clinical conditions.
KW - Arrhythmias
KW - Digoxin
KW - Fetal echocardiography
KW - Flecainide
KW - Sotalol
KW - Supraventricular
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M3 - Article
C2 - 15626276
AN - SCOPUS:16644369065
VL - 5
SP - 777
EP - 780
JO - Italian Heart Journal
JF - Italian Heart Journal
SN - 1129-471X
IS - 10
ER -