Rapid control of foetal supraventricular tachycardia with digoxin and flecainide combination treatment
Cardiology in the Young, 07/17/2012
Uzun O et al. – Flecainide and digoxin combination treatment offers a safe and effective treatment for foetal supraventricular tachycardia with fast restoration of sinus rhythm.Methods
- Authors conducted a retrospective review of 29 patients diagnosed with supraventricular foetal tachycardia between 2001 and 2009.
- Mode of presentation, foetal cardiac function, maternal anti–arrhythmic serum levels, drug tolerance, and maternal electrocardiogram recordings were assessed.
- The postnatal outcome of each infant was also evaluated for tachycardia recurrence.
- In all, 27 foetuses were treated with digoxin and flecainide combination, and two foetuses were delivered without any treatment.
- Of the 27 foetuses, seven had atrial flutter and the remaining 22 had atrioventricular re–entry tachycardia.
- There were eight foetuses with hydrops (27%), of whom three had atrial flutter and five had atrioventricular re–entry tachycardia; 26 foetuses (96%) responded to flecainide and digoxin combination, with restoration of sinus rhythm in 22 (81.4%) and rate control in the other four.
- In one severely hydropic foetus, there was no response to treatment.
- In all, 26 treated infants were delivered alive, but one pregnancy was terminated for non–cardiac causes when the foetus was in sinus rhythm.
- There was no intrauterine death due to tachycardia.
- Although there were minor side effects to anti–arrhythmic medications, none of the pregnant women developed proarrhythmia.