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Fetal Tachycardia

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1. Treatment of fetal supraventricular tachycardia by intra-amniotic administration of digoxin. (PubMed)

Treatment of fetal supraventricular tachycardia by intra-amniotic administration of digoxin. Fetal arrhythmias occur in as many as 1- 3% of pregnancies1 . Supraventricular tachycardia (SVT) accounts for about 66-90% of fetal tachyarrhythmia2 . First-line therapy has not been determined in randomized trials, but digoxin has been considered the first-choice drug. Flecainide and sotalol have been advocated as second-choice drugs, though flecainide might be more effective as a first-line treatment3

2019 Ultrasound in Obstetrics and Gynecology

2. Guidelines on Supraventricular Tachycardia (for the management of patients with)

Guidelines on Supraventricular Tachycardia (for the management of patients with) 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC) | European Heart Journal | Oxford Academic ') We use cookies to enhance your experience on our website.By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie (...) settings at any time. Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term Close search filter search input Article Navigation Close mobile search navigation Article Navigation Article Contents Article Navigation 2019 ESC Guidelines for the management of patients with supraventricular tachycardia The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European

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2019 European Society of Cardiology

3. Prospective Observational Cohort Study of Fetal Atrial Flutter & Supraventricular Tachycardia

Prospective Observational Cohort Study of Fetal Atrial Flutter & Supraventricular Tachycardia Prospective Observational Cohort Study of Fetal Atrial Flutter & Supraventricular Tachycardia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Prospective Observational Cohort Study of Fetal Atrial Flutter & Supraventricular Tachycardia (FAST Registry) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03376438 Recruitment Status

2017 Clinical Trials

4. Transplacental Treatment of Fetal Tachycardia: A Systematic Review and Meta-analysis. (PubMed)

Transplacental Treatment of Fetal Tachycardia: A Systematic Review and Meta-analysis. Multiple transplacental medications can be used to treat fetal tachycardia. We sought to perform a systematic review and meta-analysis to determine whether digoxin, flecainide, or sotalol was the most efficacious therapy for converting fetal tachycardia to sinus rhythm.We performed a systematic review and meta-analysis to compare digoxin, flecainide, or sotalol as first-line therapy for fetal tachycardia (...) . Studies were identified by a search of PubMed (Medline), Web of Science, and Scopus.There were 21 studies included. Flecainide (OR: 1.4, 95% CI: 1.1-2.0, I2  = 60%, P = 0.03) and sotalol (OR:1.4, 95% CI:1.1-2.0, I2  = 30%, P = 0.02) were superior to digoxin for conversion of fetal tachycardia to sinus rhythm. In those with hydrops, the benefit over digoxin was more notable for both flecainide (OR: 5.0, 95% CI: 2.5-10.0, I2  = 0%, P < 0.001) and sotalol (OR: 2.5, 95% CI: 1.7-5.0, I2  = 0%, P < 0.001

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2017 Prenatal diagnosis

5. Postnatal Outcomes of Fetal Supraventricular Tachycardia: a Multicenter Study. (PubMed)

Postnatal Outcomes of Fetal Supraventricular Tachycardia: a Multicenter Study. Supraventricular tachycardia (SVT), the most common fetal tachycardia, can be difficult to manage in utero. We sought to better understand predictors of the postnatal clinical course in neonates who experienced fetal SVT. We hypothesized that fetuses with hydrops or those with refractory SVT (failure of first-line SVT therapy) are more likely to experience postnatal SVT. This was a retrospective multicenter cohort (...) study of subjects diagnosed with fetal SVT between 2006 and 2014. Fetuses with structural heart disease were excluded. Descriptive comparative statistics and univariate analysis with logistic regression were utilized to determine factors that most strongly predicted postnatal SVT and preterm delivery. The cohort consisted of 103 subjects. Refractory SVT was found in 37% (N = 38) of the cohort with this group more likely to be delivered prematurely (median = 36 vs. 37.5 weeks, p = 0.04). Refractory

2017 Pediatric Cardiology

6. Transient Fetal Tachycardia After Intravenous Diphenhydramine Administration. (PubMed)

Transient Fetal Tachycardia After Intravenous Diphenhydramine Administration. Fetal tachycardia is attributable to a variety of etiologies, including an untreated maternal medical condition or an indicator of potential fetal compromise. Maternal medication administration may also affect the fetal heart rate.A 28-year-old nulliparous patient at 41 weeks of gestation was treated for pruritus with intravenous diphenhydramine after epidural administration of fentanyl. Within 14 minutes, the fetal (...) heart rate increased from a baseline of 155 beats per minute (bpm) to more than 200 bpm while maintaining moderate variability. This was accompanied by an increase in uterine contractions occurring every 1.5 minutes. The fetal tachycardia lasted 51 minutes; several hours later, a healthy neonate was delivered.Diphenhydramine may produce transient fetal tachycardia as well as increased maternal uterine activity.

2017 Obstetrics and Gynecology

7. Potential utility of pulsed Doppler for prenatal diagnosis of fetal ventricular tachycardia secondary to long QT syndrome. (PubMed)

Potential utility of pulsed Doppler for prenatal diagnosis of fetal ventricular tachycardia secondary to long QT syndrome. 28741754 2018 10 19 2018 10 19 1469-0705 51 5 2018 May Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Ultrasound Obstet Gynecol Potential utility of pulsed-wave Doppler for prenatal diagnosis of fetal ventricular tachycardia secondary to long QT syndrome. 697-699 10.1002/uog.18819 Miyoshi (...) , 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan. Ikeda T T Department of Obstetrics and Gynecology, Mie University, Tsu, Japan. eng Case Reports Letter England Ultrasound Obstet Gynecol 9108340 0960-7692 0 Anti-Arrhythmia Agents 7487-88-9 Magnesium Sulfate IM Adult Anti-Arrhythmia Agents administration & dosage Cesarean Section Electrocardiography Female Fetal Heart diagnostic imaging Humans Long QT Syndrome diagnostic imaging drug therapy Magnesium Sulfate administration & dosage Pregnancy

2017 Ultrasound in Obstetrics and Gynecology

8. Successful prenatal management of ventricular tachycardia and second-degree atrioventricular block in fetal long QT syndrome (PubMed)

Successful prenatal management of ventricular tachycardia and second-degree atrioventricular block in fetal long QT syndrome 28491768 2019 02 26 2214-0271 3 1 2017 Jan HeartRhythm case reports HeartRhythm Case Rep Successful prenatal management of ventricular tachycardia and second-degree atrioventricular block in fetal long QT syndrome. 53-57 10.1016/j.hrcr.2016.09.001 Miyake Akira A Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. Sakaguchi Heima (...) , National Cerebral and Cardiovascular Center, Osaka, Japan. eng Case Reports 2016 09 21 United States HeartRhythm Case Rep 101656239 2214-0271 Congenital long QT syndrome Fetal magnetocardiography Prenatal management Ventricular arrhythmia Ventricular tachycardia/torsades de pointes 2017 5 12 6 0 2017 5 12 6 0 2017 5 12 6 1 epublish 28491768 10.1016/j.hrcr.2016.09.001 S2214-0271(16)30106-3 PMC5420015 J Am Coll Cardiol. 2009 Nov 24;54(22):2052-62 19926013 Ultrasound Obstet Gynecol. 2009 Oct;34(4):475-80

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2016 HeartRhythm Case Reports

9. Fetal Tachycardia

Fetal Tachycardia Fetal Tachycardia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Tachycardia Fetal Tachycardia Aka: Fetal (...) Tachycardia , FHR Tachycardia From Related Chapters II. Definition >160 bpm III. Mild Fetal Tachycardia (FHR 160-180 bpm) Usually benign if normal Other causes Maternal fever, dehydration or anxiety Maternal ketosis Medications s (e.g. ) medications (e.g. ) Fetal movement Preterm Fetus Maternal Maternal IV. Significant Fetal Tachycardia (FHR >180 bpm) (especially if maternal fever) Fetal arrhythmia or congenital defect (FHR >200 bpm) V. References Bailey (2000) ALSO, E:1-13 Gabbe (2002) Obstetrics, p. 395

2018 FP Notebook

10. High Dose Flecainide is the Most Effective Treatment for Fetal Supraventricular Tachycardia. (PubMed)

High Dose Flecainide is the Most Effective Treatment for Fetal Supraventricular Tachycardia. Fetal tachyarrhythmia can lead to fetal hydrops due to heart failure. Flecainide is often considered as second-line therapy when digoxin monotherapy fails, which is more likely in hydropic fetuses. Time to conversion to sinus rhythm (SR) is critical in cases presenting with hydrops.The aim of this study was to evaluate the efficacy and time to conversion to SR of transplacental treatment, especially (...) tolerated.Flecainide is highly effective in achieving SR in hydropic and nonhydropic fetuses with supraventricular tachycardia in a median time of 3 days. In our opinion, flecainide should be considered as first-line therapy in fetal supraventricular tachycardia with and without hydrops.Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

2016 Heart Rhythm

11. Flecainide versus digoxin for fetal supraventricular tachycardia: Comparison of two drug treatment protocols. (PubMed)

Flecainide versus digoxin for fetal supraventricular tachycardia: Comparison of two drug treatment protocols. The optimal treatment for fetal supraventricular tachycardia (SVT) with 1:1 atrioventricular relationship is unclear.We compared the effectiveness of transplacental treatment protocols used in 2 centers.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 (...) with flecainide.Flecainide was more effective than digoxin, especially when hydrops was present. No adverse fetal outcomes were attributed to flecainide.Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

2016 Heart Rhythm

12. Digoxin Therapy of Fetal Superior Ventricular Tachycardia: Are Digoxin Serum Levels Reliable? (PubMed)

Digoxin Therapy of Fetal Superior Ventricular Tachycardia: Are Digoxin Serum Levels Reliable? Despite its seldom occurrence, fetal tachycardia can lead to poor fetal outcomes including hydrops and fetal death. Management can be challenging and result in maternal adverse effects secondary to high serum drug levels required to achieve effective transplacental antiarrhythmic drug therapy.A 33-year-old woman at 33 weeks of gestation with a diagnosis of a fetal sustained superior ventricular (...) tachycardia developed chest pain, shortness of breath, and bigeminy on electrocardiogram secondary to digoxin toxicity despite subtherapeutic serum drug levels. She required supportive care with repletion of corresponding electrolyte abnormalities. After resolution of cardiac manifestations of digoxin toxicity, the patient was discharged home. The newborn was discharged at day 9 of life on maintenance amiodarone.We describe an interesting case of digoxin toxicity with cardiac manifestations of digoxin

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2016 AJP Reports

13. A prospective cohort study of fetal heart rate monitoring: deceleration area is predictive of fetal acidemia

 minutes of tachycardia had the greatest discriminative ability for neonatal morbidity (area under the receiver operating characteristic curves, 0.77; 95% confidence interval, 0.75-0.79). Once the threshold of deceleration area is reached the number of cesareans needed-to-be performed to potentially prevent 1 case of acidemia and morbidity is 5 and 6, respectively.Deceleration area is the most predictive electronic fetal monitoring pattern for acidemia, and combined with tachycardia for significant (...) A prospective cohort study of fetal heart rate monitoring: deceleration area is predictive of fetal acidemia Intrapartum electronic fetal monitoring is the most commonly used tool in obstetrics in the United States; however, which electronic fetal monitoring patterns predict acidemia remains unclear.This study was designed to describe the frequency of patterns seen in labor using modern nomenclature, and to test the hypothesis that visually interpreted patterns are associated with acidemia

2018 EvidenceUpdates

14. ShortGuide: Fetal movements

-maternal transfusion or chronic small volume over time may lead to fetal compromise and or fetal death 5 · Associated signs of fetal anaemia may include: o CTG–reduced or absent variability 5 ; unexplained fetal tachycardia; sinusoidal FHR · USS–elevated middle cerebral artery Doppler peak systolic velocity (MCA PSV) 20 ; ascities or fetal hydrops · If positive result check maternal blood group and consider RhD immunoglobulin in Rh negative woman Ongoing management Aspect Consideration Antenatal (...) ShortGuide: Fetal movements IMPORTANT: Consider individual clinical circumstances. Read the full disclaimer at https://www.health.qld.gov.au/qcg Available from: www.health.qld.gov.au/qcg Effective: October 2018 | Review: October 2023 | Doc No: MN18.46-V1-R23 Queensland Health Queensland Clinical Guidelines short GUIDE Fetal movements Clinical significance Aspect Consideration Clinical significance · Maternal perception of her baby’s normal pattern of movements: o Indicates a well baby o

2019 Queensland Health

15. Intrapartum fetal surveillance

intrapartum CTG is unclear and may be related to the fetus moving less Normal intrapartum Term 1 · Baseline FHR of 110–160 bpm · Normal baseline variability present · Accelerations may or may not be present · No decelerations Preterm 28 · Baseline fetal heart at 20–24 weeks averages 155 bpm decreasing with advancing gestational age · Baseline rate will be around the upper limits of normal o Tachycardia reduces with gestational age · Baseline variability may be reduced due to tachycardia in preterm fetus (...) or presentation 3 Uterine hyperstimulation (tachysystole or hypertonus) · Oxytocin infusion · Recent vaginal prostaglandins insertion · Stop Oxytocin infusion 3,22 while reassessing labour and fetal state · Remove Prostaglandins (PGE2/Cervidil) o Refer to Queensland Clinical Guideline Induction of labour 22 · Terbutaline 250 micrograms subcutaneously or intravenously (IV) 2,3,11 · Sublingual Glyceryl Trinitrate* (GTN) spray 400 micrograms 2 · Salbutamol 100 micrograms IV 2 Maternal tachycardia/ pyrexia

2019 Queensland Health

16. Vibroacoustic stimulation for fetal assessment in labour in the presence of a nonreassuring fetal heart rate trace. (PubMed)

Vibroacoustic stimulation for fetal assessment in labour in the presence of a nonreassuring fetal heart rate trace. Fetal vibroacoustic stimulation (VAS) is a simple, non-invasive technique where a device is placed on the maternal abdomen over the region of the fetal head and sound is emitted at a predetermined level for several seconds. It is hypothesised that the resultant startle reflex in the fetus and subsequent fetal heart rate (FHR) acceleration or transient tachycardia following VAS (...) provide reassurance of fetal well-being. This technique has been proposed as a tool to assess fetal well-being in the presence of a nonreassuring cardiotocographic (CTG) trace during the first and second stages of labour.To evaluate the clinical effectiveness and safety of VAS in the assessment of fetal well-being during labour, compared with mock or no stimulation for women with a singleton pregnancy exhibiting a nonreassuring FHR pattern.We searched the Cochrane Pregnancy and Childbirth Group's

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2013 Cochrane

17. The Relationship Between Fetal Baseline Heart-rate and the Level of Acetyl-choline Esterase in Fetal Blood

beats per minute and 140-160 beats per minute. Criteria Inclusion Criteria: Pregnant women between 32 and 41 weeks` gestation undergoing either vaginal or cesarean delivery with a fetal baseline heart rate of 110-130 beats per minute and 140-160 beats per minute. Exclusion Criteria: Delivery before 32 weeks of gestation Maternal bradycardic (<60) or tachycardic (>100) resting heart rate. Fetal bradycardia (<110) or tachycardia (>160). Suspected chorioamnionitis Maternal diseases which can affect her (...) The Relationship Between Fetal Baseline Heart-rate and the Level of Acetyl-choline Esterase in Fetal Blood The Relationship Between Fetal Baseline Heart-rate and the Level of Acetyl-choline Esterase in Fetal Blood - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100

2018 Clinical Trials

18. A prospective cohort study of fetal heart rate monitoring: Deceleration area is predictive of fetal acidemia. (PubMed)

 minutes of tachycardia had the greatest discriminative ability for neonatal morbidity (area under the receiver operating characteristic curves, 0.77; 95% confidence interval, 0.75-0.79). Once the threshold of deceleration area is reached the number of cesareans needed-to-be performed to potentially prevent 1 case of acidemia and morbidity is 5 and 6, respectively.Deceleration area is the most predictive electronic fetal monitoring pattern for acidemia, and combined with tachycardia for significant (...) A prospective cohort study of fetal heart rate monitoring: Deceleration area is predictive of fetal acidemia. Intrapartum electronic fetal monitoring is the most commonly used tool in obstetrics in the United States; however, which electronic fetal monitoring patterns predict acidemia remains unclear.This study was designed to describe the frequency of patterns seen in labor using modern nomenclature, and to test the hypothesis that visually interpreted patterns are associated with acidemia

2018 American Journal of Obstetrics and Gynecology

19. Novel fetal ectopic atrial tachycardia findings on cardiotocography. (PubMed)

Novel fetal ectopic atrial tachycardia findings on cardiotocography. 25612321 2016 09 13 2016 11 26 1469-0705 46 5 2015 Nov Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Ultrasound Obstet Gynecol Novel findings of fetal ectopic atrial tachycardia by cardiotocography. 629-30 10.1002/uog.14797 Miyoshi T T Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka (...) Ultrasound Obstet Gynecol 9108340 0960-7692 0 Anti-Arrhythmia Agents 73K4184T59 Digoxin IM Anti-Arrhythmia Agents administration & dosage Cardiotocography Cesarean Section Digoxin administration & dosage Female Humans Infant, Newborn Male Pregnancy Pregnancy Outcome Tachycardia, Ectopic Atrial diagnostic imaging drug therapy embryology Ultrasonography 2014 12 05 2015 01 13 2015 01 15 2015 1 23 6 0 2015 1 23 6 0 2016 9 14 6 0 ppublish 25612321 10.1002/uog.14797

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2015 Ultrasound in Obstetrics and Gynecology

20. Minimal Use of Fluoroscopy to Reduce Fetal Radiation Exposure during Radiofrequency Catheter Ablation of Maternal Supraventricular Tachycardia (PubMed)

Minimal Use of Fluoroscopy to Reduce Fetal Radiation Exposure during Radiofrequency Catheter Ablation of Maternal Supraventricular Tachycardia Electrophysiologic procedures in the young engender concern about the potential long-term effects of radiation exposure. This concern is manifold if such procedures are contemplated during pregnancy. Catheter ablations in pregnancy are indicated only in the presence of an unstable tachycardia that cannot be controlled by antiarrhythmic agents

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2015 Texas Heart Institute Journal

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