Key result
Transplacental administration of flecainide successfully cardioverted refractory fetal supraventricular tachycardia, stabilizing the fetal heart rate at 130-140 bpm and allowing the pregnancy to continue to 36 weeks and 6 days.
Why the study?
Fetal supraventricular tachycardia is challenging to manage, particularly in refractory cases where maternal well-being must be balanced against fetal progression to hydrops fetalis or permanent cardiac dysfunction.
Case Report (n=1)
No
This case report highlights the complexity of managing refractory fetal supraventricular tachycardia and the need for multiple treatment pathways to prevent severe complications like hydrops fetalis.
Answers are grounded in this paper and cite their sources.
Case supports individualized multi-agent approaches in refractory fetal SVT; leaves open standardized protocols for prospective validation.
Fetal supraventricular tachycardia can be difficult to manage and offers a challenging treatment course, particularly in refractory cases. The treatment course must balance maternal well-being with the health status of the fetus, all while racing against possible progression to hydrops fetalis or permanent cardiac dysfunction. We describe a case of fetal supraventricular tachycardia that demonstrates many of these concepts, as well as the importance of utilizing several treatment pathways in refractory cases.
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Celentano et al. (2022) conducted a case report in Refractory Fetal Supraventricular Tachycardia (n=1). Transplacental antiarrhythmic therapy (sotalol, digoxin, flecainide) was evaluated on Fetal heart rate stabilization and cardioversion. Transplacental administration of flecainide successfully cardioverted refractory fetal supraventricular tachycardia, stabilizing the fetal heart rate at 130-140 bpm and allowing the pregnancy to continue to 36 weeks and 6 days.
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