Pediatric Drugs

, Volume 4, Issue 1, pp 49–63 | Cite as

Drug Treatment of Fetal Tachycardias

  • Martijn A. Oudijk
  • Jopje M. Ruskamp
  • Barbara E. Ambachtsheer
  • Tessa F. F. Ververs
  • Philip Stoutenbeek
  • Gerard H. A. Visser
  • Erik J. Meijboom
Review Article

Abstract

The pharmacological treatment of fetal tachycardia (FT) has been described in various publications. We present a study reviewing the necessity for treatment of FT, the regimens of drugs used in the last two decades and their mode of administration.

The absence of reliable predictors of fetal hydrops (FH) has led most centers to initiate treatment as soon as the diagnosis of FT has been established, although a small minority advocate nonintervention. As the primary form of pharmacological intervention, oral maternal transplacental therapy is generally preferred.

Digoxin is the most common drug used to treat FT; however, effectiveness remains a point of discussion. After digoxin, sotalol seems to be the most promising agent, specifically in atrial flutter and nonhydropic supraventricular tachycardia (SVT). Flecainide is a very effective drug in the treatment of fetal SVT, although concerns about possible pro-arrhythmic effects have limited its use. Amiodarone has been described favorably, but is frequently excluded due to its poor tolerability. Verapamil is contraindicated as it may increase mortality. Conclusions on other less frequently used drugs cannot be drawn.

In severely hydropic fetuses and/or therapy-resistant FT, direct fetal therapy is sometimes initiated. To minimize the number of invasive procedures, fetal intramuscular or intraperitoneal injections that provide a more sustained release are preferred.

Based on these data we propose a drug protocol of sotalol 160mg twice daily orally, increased to a maximum of 480mg daily. Whenever sinus rhythm is not achieved, the addition of digoxin 0.25mg three times daily is recommended, increased to a maximum of 0.5mg three times daily. Only in SVT complicated by FH, either maternal digoxin 1 to 2mg IV in 24 hours, and subsequently 0.5 to 1 mg/day IV, or flecainide 200 to 400 mg/day orally is proposed. Initiating direct fetal therapy may follow failure of transplacental therapy.

Keywords

Digoxin Amiodarone Sotalol Disopyramide Flecainide 

Notes

Acknowledgements

No sources of funding were used in the preparation of this manuscript and the authors acknowledge there are no conflicts of interest.

References

  1. 1.
    Bergmans MGM, Jonker GJ, Kock HCL. Fetal supraventricular tachycardia: review of the literature. Obstet Gynecol Surv 1985; 40: 61–8PubMedGoogle Scholar
  2. 2.
    Kleinman CS, Donnerstein RL, Jaffe CC, et al. Fetal echocardiography: a tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy, analysis of 71 patients. Am J Cardiol 1983; 51: 237–42PubMedGoogle Scholar
  3. 3.
    Allan LD, Anderson RH, Sullivan ID, et al. Evaluation of fetal arrhythmias by echocardiography. Br Heart J 1983; 50: 240–5PubMedGoogle Scholar
  4. 4.
    Kleinman CS, Copel JA, Weinstein EM, et al. Treatment of fetal supraventricular tachyarrhythmias. J Clin Ultrasound 1985; 13: 265–73PubMedGoogle Scholar
  5. 5.
    Wladimiroff JW, Stewart PA. Treatment of fetal cardiac arrhythmias. Br J Hosp Med 1985; 34: 134–40PubMedGoogle Scholar
  6. 6.
    Simpson LL, Marx GR, D’Alton ME. Supraventricular tachycardia in the fetus: conservative management in the absence of hemodynamic compromise. J Ultrasound Med 1997; 16: 459–64PubMedGoogle Scholar
  7. 7.
    Gunteroth WG, Cyr DR, Shields LE, et al. Rate-based management of fetal supraventricular tachycardia. J Ultrasound Med 1996; 15: 453–8Google Scholar
  8. 8.
    Rooth G, Huch A, Huch R. Guidelines for the use of fetal monitoring. Int J Gynecol Obstet 1987; 25: 159–67Google Scholar
  9. 9.
    Nijhuis IJM, ten Hof J, Mulder EJH, et al. Antenatal fetal heart rate monitoring: normograms and minimal duration of recordings. Prenat Neonat Med 1998; 3: 314–22Google Scholar
  10. 10.
    Kleinman CS, Nehgme R, Copel JA. Fetal cardiac arrhythmias: diagnosis and therapy. In: Creasy RK, Resnik R, editors. Maternal-fetal medicine. Philadelphia (PA): Saunders, 1998: 301–318Google Scholar
  11. 11.
    Jaeggi E, Fouron JC, Drblik SP. Fetal atrial flutter: diagnosis, clinical features, treatment, and outcome. J Pediatr 1998; 132: 335–9PubMedGoogle Scholar
  12. 12.
    Sonesson SE, Fouron JC, Wesslen-Eriksson E, et al. Foetal supraventricular tachycardia treated with sotalol. Acta Paediatr 1998; 87: 584–7PubMedGoogle Scholar
  13. 13.
    Allan LD, Chita SK, Sharland GK, et al. Flecainide in the treatment of fetal tachycardias. Br Heart J 1991; 65: 46–8PubMedGoogle Scholar
  14. 14.
    Azancot-Benisty A, Jacqz-Aigrain E, Guirgis NM, et al. Clinical and pharmacologic study of fetal supraventricular tachyarrhythmias. J Pediatr 1992; 121: 608–13PubMedGoogle Scholar
  15. 15.
    Azancot-Benisty A, Areias JC, Oberhänsli I, et al. European study on maternal and fetal management of fetal supraventricular tachyarrhythmia: proposed protocol for an international project. J Matern Fetal Invest 1998; 8: 92–7Google Scholar
  16. 16.
    Oudijk MA, Michon MM, Kleinman CS, et al. Sotalol in the treatment of fetal dysrhythmias. Circulation 2000; 101: 2721–6PubMedGoogle Scholar
  17. 17.
    van Engelen AD, Weijtens O, Brenner JI, et al. Management, outcome and follow-up of fetal tachycardia. J Am Coll Cardiol 1994; 24: 1371–5PubMedGoogle Scholar
  18. 18.
    Frohn-Mulder IM, Stewart PA, Witsenburg M, et al. The efficacy of flecainide versus digoxin in the management of fetal supraventricular tachycardia. Pren Diagn 1995; 15: 1297–302Google Scholar
  19. 19.
    Simpson JM, Sharland GK. Fetal tachycardias: management and outcome of 127 consecutive cases. Heart 1998; 79: 576–81PubMedGoogle Scholar
  20. 20.
    Dohery JE. Digitalis glycosides pharmacokinetics and their clinical implications. Ann Intern Med 1973; 79: 229–38Google Scholar
  21. 21.
    Heaton FC, Vaughan R. Intrauterine supraventricular tachycardia: cardioversion with maternal digoxin. Obstet Gynecol 1982; 60(6): 749–52PubMedGoogle Scholar
  22. 22.
    Copel JA, Friedman AH, Kleinman CS. Management of fetal cardiac arrhythmias. Obstet Gynecol Clin North Am 1997; 24: 201–11PubMedGoogle Scholar
  23. 23.
    Rogers MC, Willerson JT, Goldblatt A, et al. Serum digoxin concentrations in the human fetus, neonate and infant. N Engl J Med 1972; 16: 1010–3Google Scholar
  24. 24.
    Spinnato JA, Shaver DC, Flinn GS, et al. Fetal supraventricular tachycardia: in utero therapy with digoxin and quinidine. Obstet Gynecol 1984; 64: 730–5PubMedGoogle Scholar
  25. 25.
    Weiner CP, Thompson MI. Direct treatment of fetal supraventricular tachycardia after failed transplacental therapy. Am J Obstet Gynecol 1988; 158: 570–3PubMedGoogle Scholar
  26. 26.
    Maxwell DJ, Crawford DC, Curry PVM, et al. Obstetric importance, diagnosis, and management of fetal tachycardias. BMJ 1988; 297: 107–10PubMedGoogle Scholar
  27. 27.
    Rogers MC, Willerson JT, Goldblatt A, et al. Serum digoxin concentrations in the human fetus, neonate and infant. N Engl J Med 1972; 16: 1010–3Google Scholar
  28. 28.
    Chan V, Tse TF, Wong V. Transfer of digoxin across the placenta and into breast milk. Br J Obstet Gynaecol 1978; 85: 605–9PubMedGoogle Scholar
  29. 29.
    Vintzileos AM, Campbell WA, Soberman SM, et al. Fetal atrial flutter and x-linked dominant vitamin D-resistent rickets. Obstet Gynecol 1985; 65(3 Suppl.): 39–44SGoogle Scholar
  30. 30.
    Kofinas AD, Simon NV, Sagel H, et al. Treatment of fetal supraventricular tachycardia with flecainide acetate after digoxin failure. Am J Obstet Gynecol 1991; 165: 630–1PubMedGoogle Scholar
  31. 31.
    Hallak M, Neerhof MG, Perry R, et al. Fetal supraventricular tachycardia and hydrops fetalis: combined intensive, direct, and transplacental therapy. Obstet Gynecol 1991; 78: 523–5PubMedGoogle Scholar
  32. 32.
    Younis JS, Granat M. Insufficient transplacental digoxin transfer in severe hydrops fetalis. Am J Obstet Gynecol 1987; 157: 1268–9PubMedGoogle Scholar
  33. 33.
    Naumburg E, Riesenfeld T, Axelsson O. Fetal tachycardia: intrauterine and postnatal course. Fetal Diagn Ther 1997; 12: 205–9PubMedGoogle Scholar
  34. 34.
    Maeda H, Koyanagi T, Nakano H. Intrauterine treatment on non-immune hydrops fetalis. Early Hum Dev 1992; 29: 241–9PubMedGoogle Scholar
  35. 35.
    Aselton P, Jick H, Milunsky A, et al. First-trimester drug use and congenital disorders. Am J Obstet Gynecol 1985; 65: 451–5Google Scholar
  36. 36.
    Hansmann M, Gembruch U, Bald R, et al. Fetal tachyarrhythmias: transplacental and direct treatment of the fetus. A report of 60 cases. Ultrasound Obstet Gynecol 1991; 1: 162–70PubMedGoogle Scholar
  37. 37.
    Amano K, Harada Y, Shoda T, et al. Successful treatment of supraventricular tachycardia with flecainide acetate: a case report. Fetal Diagn Ther 1997; 12: 328–31PubMedGoogle Scholar
  38. 38.
    Won HS, Lee IS, Yoo SJ, et al. Two cases of atrial flutter with fetal hydrops: successful fetal drug therapy. J Korean Med Sci 1998; 13(6): 676–9PubMedGoogle Scholar
  39. 39.
    Wren C, Hunter S. Maternal administration of flecainide to terminate and suppress fetal tachycardia. BMJ 1988; 296: 249PubMedGoogle Scholar
  40. 40.
    Macphail S, Walkinshaw SA. Fetal supraventricular tachycardia: detection by routine auscultation and successful in-utero management. Br J Obstet Gynecol 1988; 95: 1073–6Google Scholar
  41. 41.
    Perry JC, Ayres NA, Carpenter RJ. Fetal supraventricular tachycardia treated with flecainide acetate. J Pediatr 1990; 118: 303–5Google Scholar
  42. 42.
    Rey E, Duperron L, Gauthier R, et al. Transplacental treatment of tachycardiainduced heart failure with verapamil and amiodarone: a case report. Am J Obstet Gynecol 1985; 153: 311–2PubMedGoogle Scholar
  43. 43.
    Belhassen A, Vaksmann G, Francart C, et al. Value of amiodarone in the treatment of fetal supraventricular tachycardia: value of an assay method. J Gynecol Obstet Biol Reprod (Paris) 1987; 16: 795–800Google Scholar
  44. 44.
    Lilja H, Karlsson K, Lindecrantz K, et al. Treatment of intrauterine supraventricular tachycardia with digoxin and verapamil. J Perinat Med 1984; 12: 151–4PubMedGoogle Scholar
  45. 45.
    Wiggins JW, Bowes W, Clewell W, et al. Echocardiographic diagnosis and intravenous digoxin management of fetal tachyarrhythmias and congestive heart failure. Am J Dis Child 1986; 140(3): 202–4PubMedGoogle Scholar
  46. 46.
    Killeen AA, Bowers LD. Fetal supraventricular tachycardia treated with high-dose quinidine: toxicity associated with marked elevation of the metabolite, 3(S)-3- hydroxyquinidine. Obstet Gynecol 1987; 70 (3 Pt 2): 445–9PubMedGoogle Scholar
  47. 47.
    Hill LM, Malkasian GD. The use of quinidine sulfate throughout pregnancy. Obstet Gynecol 1979; 54: 366–8PubMedGoogle Scholar
  48. 48.
    Ward RM. Maternal drug therapy for fetal disorders. Semin Perinatol 1992; 16: 12–20PubMedGoogle Scholar
  49. 49.
    Gunteroth WG, Cyr DR, Mack LA, et al. Hydrops from reciprocating atrioventricular tachycardia in a 27-week fetus requiring quinidine for conversion. Obstet Gynecol 1985; 66(3 Suppl.): S29–33Google Scholar
  50. 50.
    Wang LW, Wu JM, Lin CS, et al. Refractory fetal supraventricular tachycardia with hydrops: report of one case. Chung Hua Min Kuo Hsiao Erh Ko I Hsueh Hui Tsa Chih 1995; 36: 300–3PubMedGoogle Scholar
  51. 51.
    Evron S, Yagel S, Samueloff A, et al. Nonimmunologic hydrops fetalis: a review of 11 cases. J Perinat Med 1985; 13: 147–51PubMedGoogle Scholar
  52. 52.
    Parilla BV, Strasburger JF, Socol ML. Fetal supraventricular tachycardia complicated by hydrops fetalis: a role for direct fetal intramuscular therapy. Am J Perinatol 1996; 13: 483–6PubMedGoogle Scholar
  53. 53.
    Sherer DM, Sadovsky E, Menashe M, et al. Fetal ventricular tachycardia associated with nonimmunologic hydrops fetalis: a case report. J Reprod Med 1990; 35: 292–4PubMedGoogle Scholar
  54. 54.
    Dumesic DA, Silverman NH, Toblas S, et al. Transplacental cardioversion of fetal supraventricular tachycardia with procainamide. N Engl J Med 1982; 307: 1128–31PubMedGoogle Scholar
  55. 55.
    Allen NM, Page RL. Procainamide administration during pregnancy. Clin Pharm 1993; 12: 58–60PubMedGoogle Scholar
  56. 56.
    Lima JJ, Kuritzky PM, Schentag JJ, et al. Fetal uptake and neonatal disposition of procainamide and its acetylated metabolite: a case report. Pediatrics 1978; 61: 491–3PubMedGoogle Scholar
  57. 57.
    Kanzaki T, Murakami M, Kobayashi H, et al. Hemodynamic changes during cardioversion in utero: a case report of supraventricular tachycardia and atrial flutter. Fetal Diagn Ther 1993; 8: 37–44PubMedGoogle Scholar
  58. 58.
    Simpson LL, Marx GR, D’Alton ME. Management of supraventricular tachycardia in the fetus. Curr Opin Obstet Gynecol 1995; 7: 409–13PubMedGoogle Scholar
  59. 59.
    Battiste CE, Neff TW, Evans JF, et al. In utero conversion of supraventricular tachycardia with digoxin and procainamide at 17 weeks gestation. Am J Perinatol 1992; 9: 302–3PubMedGoogle Scholar
  60. 60.
    Silverman NH, Enderlein MA, Stanger P, et al. Recognition of fetal arrhythmias by echocardiography. J Clin Ultrasound 1985; 13: 255–63PubMedGoogle Scholar
  61. 61.
    Given BD, Phillippe M, Saunders SP, et al. Procainamide cardioversion of fetal supraventricular tachyarrhythmia. Am J Cardiol 1984; 53: 1460–1PubMedGoogle Scholar
  62. 62.
    Shaxted EJ, Milton PJ. Disopyramide in pregnancy: a case report. Curr Med Res Opin 1979; 6: 70–2PubMedGoogle Scholar
  63. 63.
    Ellsworth AJ, Horn JR, Raisys VA, et al. Disopyramide and N-monodesalkyl disopyramide in serum and breast milk. Drug Intell Clin Pharm 1989; 23: 56–7Google Scholar
  64. 64.
    Abbi M, Kriplani A, Singh B. Preterm labor and accidental hemorrhage after disopyramide therapy in pregnancy: a case report. J Reprod Med 1999; 44(7): 653–5PubMedGoogle Scholar
  65. 65.
    Tadmor OP, Keren A, Rosenak D, et al. The effect of disopyramide on uterine contractions during pregnancy. Am J Obstet Gynecol 1990; 162: 482–6PubMedGoogle Scholar
  66. 66.
    Lui HK, Lee G, Dietrich P, et al. Flecainide induced QT prolongation and ventricular tachycardia. Am Heart J 1982; 103: 567–9PubMedGoogle Scholar
  67. 67.
    Wagner X, Jouglard J, Moulin M, et al. Coadministration of flecainide acetate and sotalol during pregnancy: lack of teratogenic effects, passage across the placenta, and excretion in human breast milk. Am Heart J 1990; 119: 700–2PubMedGoogle Scholar
  68. 68.
    Bourget P, Pons JC, Delouis C, et al. Flecainide distribution, transplacental passage, and accumulation in the amniotic fluid during the third trimester of pregnancy. Ann Pharmacother 1994; 28: 1031–4PubMedGoogle Scholar
  69. 69.
    Barjot P, Hamel P, Calmelet P, et al. Flecainide against fetal supraventricular tachycardia complicated by hydrops fetalis. Acta Obstet Gynecol Scand 1998; 77: 353–4PubMedGoogle Scholar
  70. 70.
    Vanderhal AL, Cocjin J, Santulli TV, et al. Conjugated hyperbilirubinemia in a newborn infant after maternal (transplacental) treatment with flecainide acetate for fetal tachycardia and fetal hydrops. J Pediatr 1995; 126(6): 988–90PubMedGoogle Scholar
  71. 71.
    Holmes B, Heel RC. Flecainide: a preliminary review of its pharmacodynamic properties and therapeutic efficacy. Drugs 1985; 29: 1–33PubMedGoogle Scholar
  72. 72.
    Estes III NA, Garan H, Ruskin JN. Electrophysiologic properties of flecainide acetate. Am J Cardiol 1984; 53: 26–29BGoogle Scholar
  73. 73.
    Trotter A, Kaestner M, Pohlandt F, et al. Unusual electrocardiogram findings in a preterm infant after fetal tachycardia with hydrops treated with flecainide. Pediatr Cardiol 2000; 21: 259–62PubMedGoogle Scholar
  74. 74.
    Echt DS, Liebson PR, Mitchell LB, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo, the cardiac arrhythmia suppression trial. N Engl J Med 1991; 324: 781–8PubMedGoogle Scholar
  75. 75.
    Perry JC, Garson A. Flecainide acetate for treatment of tachyarrhythmias in children: review of world literature on efficacy, safety and dosing. Am Heart J 1992; 124: 1614–21PubMedGoogle Scholar
  76. 76.
    Fish FA, Gillette PC, Benson DW. Proarrhythmia, cardiac arrest and death in young patients receiving encainide and flecainide. J Am Coll Cardiol 1991; 18: 356–65PubMedGoogle Scholar
  77. 77.
    Smoleniec JS, Martin R, James DK. Intermittent fetal tachycardia and fetal hydrops. Arch Dis Child 1991; 66: 1160–1PubMedGoogle Scholar
  78. 78.
    Tikanoja T, Kirkinen P, Nikolajev K, et al. Familial atrial fibrillation with fetal onset. Heart 1998; 79: 195–7PubMedGoogle Scholar
  79. 79.
    Edwards A, Peek MJ, Curren J. Transplacental flecainide therapy for supraventricular tachycardia in a twin pregnancy. Aust NZ J Obstet Gynaecol 1999; 39(1): 110–2Google Scholar
  80. 80.
    Fesslova V, Villa L, Nicolini U. Fetal hydrops due to a tachyarrhythmia progressing to organic pulmonary stenosis. Cardiol Young 2000; 10(2): 158–61PubMedGoogle Scholar
  81. 81.
    Hamel P, Febbraro W, Barjot P, et al. Flecainide: drug of choice for supraventricular tachycardias with anasarca. A case report. J Gynecol Obstet Biol Reprod 1997; 26(1): 37–9Google Scholar
  82. 82.
    Teuscher A, Bossie E, Imhof P. Effect of propranolol on fetal tachycardia in diabetic pregnancy. Am J Cardiol 1978; 42: 304–7PubMedGoogle Scholar
  83. 83.
    Smith MT, Livingstone I, Eadie MJ, et al. Metabolism of propranolol in the human maternal-placental-foetal unit. Eur J Clin Pharmacol 1983; 24: 727–32PubMedGoogle Scholar
  84. 84.
    Cottril CM, McAllister RG, Gettes L, et al. Propranolol therapy during pregnancy, labor and delivery: for transplacental drug transfer and impaired neonatal drug disposition. J Pediatr 1977; 91: 812–4Google Scholar
  85. 85.
    Ito S, Magee L, Smallhorn J. Drug therapy for fetal arrhythmias. Clin Perinatol 1994; 21: 543–72PubMedGoogle Scholar
  86. 86.
    Frishman WH, Chesner M. Beta-adrenergic blockers in pregnancy. Am Heart J 1988; 115: 147–52PubMedGoogle Scholar
  87. 87.
    Gladstone GR, Hordof A, Gersony WM. Propranolol administration during pregnancy: effects on the fetus. J Pediatr 1975; 86: 962–4PubMedGoogle Scholar
  88. 88.
    Redmond GP. Propranolol and fetal growth retardation. Semin Perinatol 1982; 6: 142–7PubMedGoogle Scholar
  89. 89.
    Pruyn SC, Phelan JP, Buchanan GC. Long term propranolol therapy in pregnancy: maternal and fetal outcome. Am J Obstet Gynecol 1979; 135: 485–9PubMedGoogle Scholar
  90. 90.
    Klein AM, Holzman IR, Austin EM. Fetal tachycardia prior to the development of hydrops: attended pharmacologic cardioversion. A case report. Am J Obstet Gynecol 1979; 134: 347–8PubMedGoogle Scholar
  91. 91.
    Hohnloser SH, Woosley RL. Drug therapy: sotalol. N Engl J Med 1994; 331: 31–8PubMedGoogle Scholar
  92. 92.
    Erkkola R, Lammintausta R, Liukko P, et al. Transfer of propranolol and sotalol across the human placenta. Acta Obstet Gynecol Scand 1982; 61: 31–4PubMedGoogle Scholar
  93. 93.
    O’Hare MF, Leahey W, Murnaghan GA, et al. Pharmacokinetics of sotalol during pregnancy. Eur J Clin Pharmacol 1983; 24: 521–4PubMedGoogle Scholar
  94. 94.
    Hackett LP, Wojnar-Horton RE, Dusci LJ, et al. Excretion of sotalol in breast milk. Br J Clin Pharmacol 1990; 29: 277–8PubMedGoogle Scholar
  95. 95.
    MacNeil DJ. The side effect profile of class III drug antiarrhythmic drugs: focus on d,l-sotalol. Am J Cardiol 1997; 80(8A): 90–98GGoogle Scholar
  96. 96.
    Meden H, Neeb U. Transplacental cardioversion of fetal supraventricular tachycardia using sotalol. Z Geburtshilfe Perinatol 1990; 194: 182–4PubMedGoogle Scholar
  97. 97.
    Auzelle MP, Mensire A, Lachassine E, et al. In utero treatment of fetal tachycardias with a digitalis-beta-blocker combination: apropos of 2 cases. J Gynecol Obstet Biol Reprod (Paris) 1987; 16: 383–91Google Scholar
  98. 98.
    Amiel C, Chau C, Millet V, et al. Fetal supraventricular tachycardia: management. J Gynecol Obstet Biol Reprod (Paris) 1993; 22: 284–8Google Scholar
  99. 99.
    McKenna WJ, Harris L, Rowland E, et al. Amiodarone therapy during pregnancy. Am J Cardiol 1983; 51: 1231–3PubMedGoogle Scholar
  100. 100.
    Pitcher D, Leather HM, Storey GAC, et al. Amiodarone in pregnancy. Lancet 1983; I: 597–8Google Scholar
  101. 101.
    De Wolff D, de Schepper J, Verhaaren H, et al. Congenital hypothyroid goiter and amiodarone. Acta Pediatr Scand 1988; 77: 616–8Google Scholar
  102. 102.
    Widerhorn J, Bhandari AK, Bughi S, et al. Fetal and neonatal adverse effects profile of amiodarone treatment during pregnancy. Am Heart J 1991; 122: 1162–6PubMedGoogle Scholar
  103. 103.
    Hijazi ZM, Rosenfeld LE, Copel JA, et al. Amiodarone therapy of intractable atrial flutter in a premature hydropic neonate. Pediatr Cardiol 1992; 13: 227–9PubMedGoogle Scholar
  104. 104.
    De Catte L, de Wolff D, Smitz J, et al. Fetal hypothyroidism as a complication of amiodarone treatment for persistent fetal supraventricular tachycardia. Prenat Diagn 1994; 14: 762–5PubMedGoogle Scholar
  105. 105.
    Darwiche A, Vanlieferinghen P, Lemery D, et al. Amiodarone and fetal supraventricular tachycardia: apropos of a case with neonatal hypothydroidism. Arch Fr Pediatr 1992; 49: 729–31PubMedGoogle Scholar
  106. 106.
    Matsumura LK, Born D, Kunii IS, et al. Outcome of thyroid function in newborns from mothers treated with amiodarone. Thyroid 1992; 2: 279–81PubMedGoogle Scholar
  107. 107.
    Magee LA, Downar E, Sermer M, et al. Pregnancy outcome after gestational exposure to amiodarone in Canada. Am J Obstet Gynecol 1995; 172: 1307–11PubMedGoogle Scholar
  108. 108.
    Flack NJ, Zosmer N, Bennett PR, et al. Amiodarone given by three routes to terminate fetal atrial flutter with severe hydrops. Obstet Gynecol 1993; 82: 714–6PubMedGoogle Scholar
  109. 109.
    Schleich JM, Du Haut Cilly FB, Laurent MC, et al. Early prenatal management of a fetal ventricular tachycardia treated in utero by amiodarone with long term follow-up. Prenat Diagn 2000; 20: 449–52PubMedGoogle Scholar
  110. 110.
    Gembruch U, Manz M, Bald R, et al. Repeated intravascular treatment with amiodarone in a fetus with refractory supraventricular tachycardia and hydrops fetalis. Am Heart J 1989; 118: 1335–8PubMedGoogle Scholar
  111. 111.
    Mangione R, Guyon F, Vergnaud A, et al. Successful treatment of refractory supraventricular tachycardia by repeat intravascular injection of amiodarone with long term follow-up. Prenat Diagn 2000; 20: 449–52Google Scholar
  112. 112.
    Tran HT, Kluger J, Chow MSS. Focus on dofetilide: a selective class III antiarrhythmic agent. Hosp Formul 1995; 30: 23–7Google Scholar
  113. 113.
    Dofetilide approved for serious atrial arrhythmias. Am J Health Syst Pharm 1999; 56: 2374–75Google Scholar
  114. 114.
    Sager PT. New advances in class III antiarrhythmic drug therapy. Curr Opin Cardiol 1999; 14: 15–23PubMedGoogle Scholar
  115. 115.
    Mason BA, Ricci-Goodman J, Koos BJ. Adenosine in the treatment of maternal paroxysmal supraventricular tachycardia. Obstet Gynecol 1992; 80: 478–80PubMedGoogle Scholar
  116. 116.
    Rotmensch HH, Rotmensch S, Elkayam U. Management of cardiac arrhythmias during pregnancy: current concepts. Drugs 1987; 33: 623–33PubMedGoogle Scholar
  117. 117.
    Owen J, Colvin EV, Davis RO. Fetal death after successful conversion of fetal supraventricular tachycardia with digoxin and verapamil. Am J Obstet Gynecol 1988; 158(8): 1169–70PubMedGoogle Scholar
  118. 118.
    Harrison JK, Greenfield RA, Wharton JM, et al. Acute termination of supraventricular tachycardia by adenosine during pregnancy. Am Heart J 1992; 123: 1386–8PubMedGoogle Scholar
  119. 119.
    Kohl T, Tercanli S, Kececioglu D, et al. Direct fetal administration of adenosine for the termination of incessant supraventricular tachycardia. Obstet Gynecol 1995; 85: 873–4PubMedGoogle Scholar
  120. 120.
    Allan LD. Fetal arrhythmias. In: Wren C, Campbell S, editors. Paediatric cardiac arrhythmias. Oxford: Oxford University Press, 1996: 212–25Google Scholar
  121. 121.
    Newburger JW, Keane JF. Intrauterine supraventricular tachycardia. J Pediatr 1979; 95 (5 Pt 1): 780–6PubMedGoogle Scholar
  122. 122.
    Simpson JM, Milburn A, Yates RW, et al. Outcome of intermittent tachyarrhyth-mias in the fetus. Pediatr Cardiol 1997; 18: 78–82PubMedGoogle Scholar
  123. 123.
    Allan LD. Cardiac ultrasound of the fetus. Arch Dis Child 1984; 59: 603–4PubMedGoogle Scholar
  124. 124.
    Schade RP, Stoutenbeek P, de Vries LS, et al. Neurological morbidity after fetal supraventricular tachyarrhythmia. Ultrasound Obstet Gynecol 1999; 13: 43–7PubMedGoogle Scholar
  125. 125.
    van Leeuwen P, Hailer B, Bader W, et al. Magnetocardiography in the diagnosis of fetal arrhythmia. Br J Obstet Gynaecol 1999; 106: 1200–8PubMedGoogle Scholar
  126. 126.
    Hamada H, Horigome H, Asaka M, et al. Prenatal diagnosis of long QT syndrome using fetal magnetocardiography. Prenat Diagn 1999; 19: 677–80PubMedGoogle Scholar
  127. 127.
    Menendez T, Achenbach S, Beinder E, et al. Prenatal diagnosis of QT prolongation by magnetocardiography. Pacing Clin Electrophysiol 2000; 23: 1305–7PubMedGoogle Scholar

Copyright information

© Adis International Limited 2002

Authors and Affiliations

  • Martijn A. Oudijk
    • 1
  • Jopje M. Ruskamp
    • 2
  • Barbara E. Ambachtsheer
    • 2
  • Tessa F. F. Ververs
    • 3
  • Philip Stoutenbeek
    • 1
  • Gerard H. A. Visser
    • 1
  • Erik J. Meijboom
    • 2
  1. 1.Department of ObstetricsUniversity Medical CenterUtrechtThe Netherlands
  2. 2.Department of CardiologyUniversity Medical Center (UMC), KG 01.3190UtrechtThe Netherlands
  3. 3.Division of Hospital PharmacyUniversity Medical CenterUtrechtThe Netherlands

Personalised recommendations