Fetal supraventricular tachycardia diagnosed and treated at twenty-four weeks of gestation and after birth: A case report

Emanuele Romeo, Michele D'Alto, Maria Giovanna Russo, Berardo Sarubbi, Dominga Cardaropoli, Dario Paladini, Giuseppe Pacileo, Annalisa Annunziata, Raffaele Calabrò

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)777-780
Number of pages4
JournalItalian Heart Journal
Volume5
Issue number10
Publication statusPublished - Oct 2004

Keywords

  • Arrhythmias
  • Digoxin
  • Fetal echocardiography
  • Flecainide
  • Sotalol
  • Supraventricular

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Romeo, E., D'Alto, M., Russo, M. G., Sarubbi, B., Cardaropoli, D., Paladini, D., Pacileo, G., Annunziata, A., & Calabrò, R. (2004). Fetal supraventricular tachycardia diagnosed and treated at twenty-four weeks of gestation and after birth: A case report. Italian Heart Journal, 5(10), 777-780.