Postnatal Outcomes of Fetal Supraventricular Tachycardia: a Multicenter Study

Hinkle, Kevin; Peyvandi, Shabnam; Stiver, Corey; Killen, Stacy A.S.; Weng, Hsin‐Yi; Etheridge, Susan P.; Puchalski, Michael D.

doi:10.1007/s00246-017-1662-1

Cited by 28 publications

(16 citation statements)

References 21 publications

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“…Just over half of infants with in utero SVT had postnatal SVT, with AVRT remaining the most prevalent subtype. Postnatal SVT was seen in 66% and 61% of the fetal SVT cohorts published by van Engelen et al 7 and Hinkle et al, 19 respectively. No infants with AFL in this cohort had an episode of SVT beyond the first day of life and were significantly less likely to be discharged home on maintenance AAD therapy compared to other SVT subtypes, and.…”

Section: Discussionmentioning

confidence: 96%

Low mortality in fetal supraventricular tachycardia: Outcomes in a 30‐year single‐institution experience

O’Leary

Alexander

Bezzerides

et al. 2020

Cardiovasc electrophysiol

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Objectives: To describe a single institutional experience managing fetuses with supraventricular tachycardia (SVT) and to identify associations between patient characteristics and fetal and postnatal outcomes.Background: Sustained fetal SVT is associated with significant morbidity and mortality if untreated, yet the optimal management strategy remains unclear.Methods: Retrospective cohort study including fetuses diagnosed with sustained SVT (>50% of the diagnostic echocardiogram) between 1985 and 2018. Fetuses with congenital heart disease were excluded.Results: Sustained SVT was diagnosed in 65 fetuses at a median gestational age of 30 weeks (range, 14-37). Atrioventricular re-entrant tachycardia and atrial flutter were the most common diagnoses, seen in 41 and 16 cases, respectively. Moderate/ severe ventricular dysfunction was present in 20 fetuses, and hydrops fetalis was present in 13. Of the 57 fetuses initiated on transplacental drug therapy, 47 received digoxin first-line, yet 39 of 57 (68%) required advanced therapy with sotalol, flecainide, or amiodarone. Rate or rhythm control was achieved in 47 of 57 treated fetuses. There were no cases of intrauterine fetal demise. Later gestational age at fetal diagnosis (odds ratio [OR], 1.1, 95% confidence interval [CI], 1.01-1.2, P = .02) and moderate/severe fetal ventricular dysfunction (OR, 6.1, 95% CI, 1.7-21.6, P = .005) were associated with postnatal SVT. Two postnatal deaths occurred. Conclusions: Fetuses with structurally normal hearts and sustained SVT can be effectively managed with transplacental drug therapy with minimal risk of intrauterine fetal demise. Treatment requires multiple antiarrhythmic agents in over half of cases. Later gestational age at fetal diagnosis and the presence of depressed fetal ventricular function, but not hydrops, predict postnatal arrhythmia burden. K E Y W O R D S atrial flutter, fetal tachycardia, supraventricular tachycardia, therapy SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section. How to cite this article: O'Leary ET, Alexander ME, Bezzerides VJ, et al. Low mortality in fetal supraventricular tachycardia: Outcomes in a 30-year single-institution experience.

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Section: Discussionmentioning

confidence: 96%

Low mortality in fetal supraventricular tachycardia: Outcomes in a 30‐year single‐institution experience

O’Leary

Alexander

Bezzerides

et al. 2020

Cardiovasc electrophysiol

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“…A strong correlation was found between postnatal SVT and later gestational age at fetal SVT diagnosis. Subjects with refractory SVT or hydrops did not have a higher risk of postnatal SVT [9].…”

Section: Postnatal Outcomes Of Fetal Svtmentioning

confidence: 99%

Neonatal supraventricular tachycardia

Srinivasan¹,

Balaji²

2019

Indian Pacing and Electrophysiology Journal

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Supraventricular tachycardia (SVT) is one of the most common conditions requiring emergency cardiac care in neonates. Atrioventricular reentrant tachycardia utilizing an atrioventricular bypass tract is the most common form of SVT presenting in the neonatal period. There is high likelihood for spontaneous resolution for most of the common arrhythmia substrates in infancy. Pharmacological agents remain as the primary therapy for neonates.

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“…In the follow up after delivery, rhythm holter revealed sinus rhythm. Fetal hydrops and SVT do not carry a higher risk of postnatal SVT (16).…”

Section: Discussionmentioning

confidence: 94%

Fetal Echocardiography Characteristics in a Tertiary Center

Erolu¹

2020

Erciyes Med J

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Objective: Fetal echocardiography is an important and growing diagnostic tool for early detection of congenital heart diseases and rhythm problems. In this study, we evaluated retrospectively indications and prenatal and postnatal diagnoses for fetal echocardiography. Materials and Methods: Prenatal and postnatal echocardiographic diagnoses of the newborns and data of pregnant women who were referred to the Pediatric Cardiology Clinic of Ümraniye Training and Research Hospital between October 2018 and October 2019 and newborns were obtained from medical recordings. Results: In this study, 138 patients were included. Eighty-one (58%) indication was suspected congenital heart disease, twenty-four indications (13%) was screening test positivity, 10 hyperechogenic focus, two advanced age pregnancy, six diabetes mellitus. Two were hydrops fetalis (immune/nonimmune), five dysrhythmias, one fetal anomaly. Hereditary causes were congenital heart disease in seven previous pregnancies. Sixty-eight patients with normal fetal echocardiography were normal in the postnatal period. Diagnosis of cyanotic congenital heart diseases was 24.2% of all patients, and 47.1% were acyanotic congenital heart disease in our study population. Four of the patients had arcus aorta anomalies. One patient had sustained supraventricular tachycardia with hydrops fetalis resolved with sotalol and digoxin treatment. One patient had neonatal thyrotoxicosis because of maternal graves disease Conclusion: Fetal echocardiography is a useful and noninvasive method for early diagnosis and treatment, especially in rhythm problems. Also, diagnosis of congenital heart diseases antenatally is useful for planning the management of the disease.

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Postnatal Outcomes of Fetal Supraventricular Tachycardia: a Multicenter Study

Cited by 28 publications

References 21 publications

Low mortality in fetal supraventricular tachycardia: Outcomes in a 30‐year single‐institution experience

Low mortality in fetal supraventricular tachycardia: Outcomes in a 30‐year single‐institution experience

Neonatal supraventricular tachycardia

Fetal Echocardiography Characteristics in a Tertiary Center

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