Flecainide exposure resulted in conversion to sinus rhythm in 12 of 14 (85.7%) fetuses with atrial tachycardias and intrauterine cardiac failure.
Observational (n=14)
Does flecainide improve conversion to sinus rhythm in fetuses with atrial tachycardias and intrauterine cardiac failure?
Flecainide is effective for converting fetal atrial tachycardias to sinus rhythm, but due to potential side effects, its use should be reserved for severe cases such as fetal hydrops.
Fourteen mothers were treated with flecainide for fetal atrial tachycardias associated with intrauterine cardiac failure. Twelve of the 14 fetuses responded by conversion to sinus rhythm. One of the 12 fetuses subsequently died in utero. The remaining fetuses suffered no morbidity and were alive and well 3 months to 2 years after delivery. The two fetuses in whom atrial tachycardia did not convert with flecainide were successfully treated with digoxin. These results compare favourably with previous forms of antiarrhythmic treatment. After recent reports of the side effects of flecainide treatment, however, it has been advised that this drug should be confined to high risk patients and those with life threatening arrhythmias. The use of flecainide for fetal arrhythmias should be limited to patients with severe fetal hydrops and supraventricular tachycardias. It should not be the first drug of choice in atrial flutter.
Allan et al. (Tue,) conducted a observational in Fetal atrial tachycardias associated with intrauterine cardiac failure (n=14). Flecainide was evaluated on Conversion to sinus rhythm. Flecainide exposure resulted in conversion to sinus rhythm in 12 of 14 (85.7%) fetuses with atrial tachycardias and intrauterine cardiac failure.