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Rapid control of foetal supraventricular tachycardia with digoxin and flecainide combination treatment.
Cardiol Young. 2012 Aug; 22(4):372-80.CY

Abstract

OBJECTIVES

To evaluate the efficacy of flecainide and digoxin combination in foetal supraventricular tachycardia.

SETTING

This study was carried out in a tertiary referral centre.

METHODS

We 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.

RESULTS

In all, 27 foetuses were treated with digoxin and flecainide combination, and two foetuses were delivered without any treatment. Of the 27 foetuses treated, six [corrected] had atrial flutter and the remaining 21 [corrected] 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.

CONCLUSION

Flecainide and digoxin combination treatment offers a safe and effective treatment for foetal supraventricular tachycardia with fast restoration of sinus rhythm.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Uzun O
Department of Paediatric Cardiology, University Hospital of Wales, Cardiff, Wales, United Kingdom. orhan.uzun@wales.nhs.uk
Babaoglu K
No affiliation info available
Sinha A
No affiliation info available
Massias S
No affiliation info available
Beattie B
No affiliation info available

MeSH

AdolescentAdultAnti-Arrhythmia AgentsAtrial FlutterDigoxinDrug Therapy, CombinationEchocardiographyFemaleFetal DiseasesFlecainideGestational AgeHumansHydrops FetalisInfant, NewbornPregnancyPregnancy OutcomeRetrospective StudiesTachycardia, Atrioventricular Nodal ReentryTachycardia, SupraventricularTreatment OutcomeUltrasonography, Prenatal

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22008551

Citation

Uzun, Orhan, et al. "Rapid Control of Foetal Supraventricular Tachycardia With Digoxin and Flecainide Combination Treatment." Cardiology in the Young, vol. 22, no. 4, 2012, pp. 372-80.
Uzun O, Babaoglu K, Sinha A, et al. Rapid control of foetal supraventricular tachycardia with digoxin and flecainide combination treatment. Cardiol Young. 2012;22(4):372-80.
Uzun, O., Babaoglu, K., Sinha, A., Massias, S., & Beattie, B. (2012). Rapid control of foetal supraventricular tachycardia with digoxin and flecainide combination treatment. Cardiology in the Young, 22(4), 372-80. https://doi.org/10.1017/S1047951111001272
Uzun O, et al. Rapid Control of Foetal Supraventricular Tachycardia With Digoxin and Flecainide Combination Treatment. Cardiol Young. 2012;22(4):372-80. PubMed PMID: 22008551.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid control of foetal supraventricular tachycardia with digoxin and flecainide combination treatment. AU - Uzun,Orhan, AU - Babaoglu,Kadir, AU - Sinha,Anju, AU - Massias,Spyridon, AU - Beattie,Bryan, Y1 - 2011/09/29/ PY - 2011/10/20/entrez PY - 2011/10/20/pubmed PY - 2013/1/26/medline SP - 372 EP - 80 JF - Cardiology in the young JO - Cardiol Young VL - 22 IS - 4 N2 - OBJECTIVES: To evaluate the efficacy of flecainide and digoxin combination in foetal supraventricular tachycardia. SETTING: This study was carried out in a tertiary referral centre. METHODS: We 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. RESULTS: In all, 27 foetuses were treated with digoxin and flecainide combination, and two foetuses were delivered without any treatment. Of the 27 foetuses treated, six [corrected] had atrial flutter and the remaining 21 [corrected] 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. CONCLUSION: Flecainide and digoxin combination treatment offers a safe and effective treatment for foetal supraventricular tachycardia with fast restoration of sinus rhythm. SN - 1467-1107 UR - https://www.unboundmedicine.com/medline/citation/22008551/Rapid_control_of_foetal_supraventricular_tachycardia_with_digoxin_and_flecainide_combination_treatment_ DB - PRIME DP - Unbound Medicine ER -