Flecainide versus digoxin for fetal supraventricular tachycardia: Comparison of two drug treatment protocols

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F16%3A10327960" target="_blank" >RIV/00064203:_____/16:10327960 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11130/16:10327960

Result on the web

<a href="http://dx.doi.org/10.1016/j.hrthm.2016.03.023" target="_blank" >http://dx.doi.org/10.1016/j.hrthm.2016.03.023</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.hrthm.2016.03.023" target="_blank" >10.1016/j.hrthm.2016.03.023</a>

Result language

angličtina

Original language name

Flecainide versus digoxin for fetal supraventricular tachycardia: Comparison of two drug treatment protocols

Original language description

BACKGROUND The optimal treatment for fetal supraventricular tachycardia (SVT) with 1:1 atrioventricular relationship is unclear. OBJECTIVE We compared the effectiveness of transplacental treatment protocols used in 2 centers. METHODS Pharmacologic treatment was used in 84 fetuses. Maternal oral flecainide was the primary therapy in center 1 (n = 34) and intravenous maternal digoxin in center 2 (n = 50). SVT mechanism was classified by mechanical ventriculoatrial (VA) time intervals as short VA or long VA. Treatment success was defined as conversion to sinus rhythm (SR), or rate control, defined as >15% rate reduction. RESULTS Short VA interval occurred in 67 fetuses (80%) and long VA in 17 (20%). Hydrops was present 28 of 84 (33%). For short VA SVT, conversion to SR was 29 of 42 (69%) for digoxin and 24 of 25 (96%) for flecainide (P=.01). For long VA SVT, conversion to SR and rate control was 4 of 8 (50%) and 0 of 8, respectively, for digoxin, and 6 of 9 (67%) and 2 of 9 (cumulative 89%) for flecainide (P=.13). In nonhydropic fetuses, digoxin was successful in 23 of 29 (79%) and flecainide in 26 of 27 (96%) (P=.10). In hydrops, digoxin was successful in 8 of 21 (38%), flecainide alone in 6 of 7 (86%, P=.07 vs digoxin), and flecainide amiodarone in 7 of 7 (100%) (P=.01). Intrauterine or neonatal death occurred in 9 of 21 hydropic fetuses treated with digoxin (43%), compared to 0 of 7 (P=.06) treated with flecainide. CONCLUSIONS Flecainide was more effective than digoxin, especially when hydrops was present. No adverse fetal outcomes were attributed to flecainide.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FA - Cardiovascular diseases including cardio-surgery

OECD FORD branch

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Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2016

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Heart Rhythm

ISSN

1547-5271

e-ISSN

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Volume of the periodical

13

Issue of the periodical within the volume

9

Country of publishing house

US - UNITED STATES

Number of pages

7

Pages from-to

1913-1919

UT code for WoS article

000382307400028

EID of the result in the Scopus database

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