Transplacental Cardioversion of Fetal Supra Ventricular Tachycardia with Procainamide

Since Hyman's first phonocardiographic verification of fetal arrhythmia in 1930,1 there have been reports of persistent fetal tachycardia resulting in the delivery of infants with benign neonatal courses or severe congestive heart failure, or even in fetal loss.2 3 4 5 6 Intrauterine pharmacologic cardioversion with digoxin and propranolol has been reported previously.7 In this report we describe a case of fetal supraventricular tachycardia complicated by intrauterine congestive heart failure that was diagnosed by two-dimensional and M-mode echocardiography. The arrhythmia was temporarily cardioverted on several occasions by administering intravenous procainamide to the mother after digoxin and propranolol had failed to alter the fetal heart . . .