Pharmacological management of fetal and neonatal cardiac arrhythmias requires careful consideration of unique pharmacokinetics, limited treatment options, and potential long-term developmental risks.
This AHA scientific statement outlines current consensus and future research directions for the pharmacological management of fetal and neonatal cardiac arrhythmias.
Disorders of the cardiac rhythm may occur in both the fetus and neonate. Because of the immature myocardium, the hemodynamic consequences of either bradyarrhythmias or tachyarrhythmias may be far more significant than in mature physiological states. Treatment options are limited in the fetus and neonate because of limited vascular access, patient size, and the significant risk/benefit ratio of any intervention. In addition, exposure of the fetus or neonate to either persistent arrhythmias or antiarrhythmic medications may have yet-to-be-determined long-term developmental consequences. This scientific statement discusses the mechanism of arrhythmias, pharmacological treatment options, and distinct aspects of pharmacokinetics for the fetus and neonate. From the available current data, subjects of apparent consistency/consensus are presented, as well as future directions for research in terms of aspects of care for which evidence has not been established.
Batra et al. (Mon,) conducted a review in Cardiac arrhythmias. Pharmacological management was evaluated. Pharmacological management of fetal and neonatal cardiac arrhythmias requires careful consideration of unique pharmacokinetics, limited treatment options, and potential long-term developmental risks.