Document Detail


Management of Fetal Tachyarrhythmias.
MedLine Citation:
PMID:  15324615     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Fetal tachyarrhythmias are an important cause of fetal morbidity and mortality. The majority of fetal tachyarrhythmias are due to atrioventricular reentrant type of supraventricular tachycardia and atrial flutter. Fetal echocardiography remains the main tool of diagnosing and discerning the mechanism of tachyarrhythmia. The goals of therapy for fetal arrhythmias are to restore sinus rhythm, resolve heart failure, and postpone delivery before term. Although there is no anonymity in the approach to the drug treatment of fetal tachycardia, digoxin is the most commonly employed first-line antiarrhythmic drug for supraventricular tachycardia. In digoxin nonresponders, flecainide ( digoxin) controls tachyarrhythmia with high conversion rate. A combination of digoxin and sotalol has proved effective therapy for atrial flutter, but the proarrhythmic side effect of sotalol on the fetus has been a concern. Amiodarone has emerged as a second-line treatment after digoxin failure in nonhydropic fetuses and the most effective treatment for drug-refractory fetal tachycardia accompanied by hydrops. Both the fetus and mother should be closely monitored for the response and adverse effect of the treatment. The antiarrhythmic treatment for supraventricular tachycardia should be continued after birth and during infancy due to the high incidence of postnatal recurrence.
Authors:
Gautam K. Singh
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Current treatment options in cardiovascular medicine     Volume:  6     ISSN:  1534-3189     ISO Abbreviation:  Curr Treat Options Cardiovasc Med     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-Aug-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815942     Medline TA:  Curr Treat Options Cardiovasc Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  399-406     Citation Subset:  -    
Affiliation:
Washington University School of Medicine, Division of Cardiology, Department of Pediatrics, St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110, USA. singh_g@kids.wustl.edu
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