The effect of flecainide acetate on fetal heart rate variability: A case report

Gelder-Hasker, M. R. van; Jong, C.L.D. de; Vries, J.I.P. de; Geijn, H.P. van

doi:10.1016/0029-7844(95)00028-p

Cited by 10 publications

(4 citation statements)

References 7 publications

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“…The authors suggested that the mechanism may be an induced activation of sympathetic activity. This seems to be corroborated in a case of fetal SVT treated with flecainide in which the authors note reduced fetal HRV in spite of the presence of documented fetal movement activity 22 . Nonetheless, we found an opposite effect in the male fetus after treatment began, that is, an increase in the time‐domain HRV measures over a 6‐week period.…”

Section: Discussionsupporting

confidence: 86%

Effect of Prenatal Antiarrhythmic Treatment on Cardiac Function in a Twin Pregnancy

Leeuwen

Schiermeier

Hailer³

et al. 2008

Pacing Clinical Electrophis

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We present a case of supraventricular tachycardia affecting one fetus in a twin pregnancy. Before and after treatment with flecainide and cardioversion, we examined conduction times and heart rate variability (HRV) in both twins on the basis of magnetocardiography. Cardiac conduction times increased in both fetuses but HRV showed opposing effects with a number of HRV measures. This case demonstrates that magnetocardiography not only enables identification of fetal arrhythmia, but also permits the investigation of the effects of antiarrhythmic treatment on the conductive system as well as on interaction with the autonomic nervous system.

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Section: Discussionsupporting

confidence: 86%

Effect of Prenatal Antiarrhythmic Treatment on Cardiac Function in a Twin Pregnancy

Leeuwen

Schiermeier

Hailer³

et al. 2008

Pacing Clinical Electrophis

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“…In addition to these findings in adults, case reports have been published which describe reduced fetal HRV after prenatal treatment with Flecainide [36,37]. In line with these clinical observations, we found a reduction of shortterm variability at comparable concentrations of Flecainide.…”

Section: Ivabradinesupporting

confidence: 76%

Beat Rate Variability in Murine Embryonic Stem Cell-Derived Cardiomyocytes: Effect of Antiarrhythmic Drugs

Matzkies

Nguemo

Hescheler

et al. 2016

Cell Physiol Biochem

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Background/Aims: Heart rate variability (HRV) refers to the fluctuation of the time interval between consecutive heartbeats in humans. It has recently been discovered that cardiomyocytes derived from human embryonic and induced pluripotent stem cells show beat rate variability (BRV) that is similar to the HRV in humans. In the present study, clinical aspects of HRV were transferred to an in vitro model. The aims of the study were to explore the BRV in murine embryonic stem cell (mESC)-derived cardiomyocytes and to demonstrate the influence of antiarrhythmic drugs on BRV as has been shown in clinical trials previously. Methods: The Microelectrode Array (MEA) technique was used to perform short-term recordings of extracellular field potentials (FPs) of spontaneously beating cardiomyocytes derived from mESCs (D3 cell line, αPig-44). Offline analysis was focused on time domain and nonlinear methods. Results: The Poincaré-Plot analysis of measurements without pharmacological intervention revealed that three different shapes of scatter plots occurred most frequently. Comparable shapes have been described in clinical studies before. The antiarrhythmic drugs Ivabradine, Verapamil and Sotalol augmented BRV, whereas Flecainide decreased BRV parameters at low concentrations (SDSD 79.0 ± 8.7% of control at 10^-9 M, p < 0.05) and increased variability measures at higher concentrations (SDNN 258.8 ± 42.7% of control at 10^-5 M, p < 0.05). Amiodarone and Metoprolol did not alter BRV significantly. Conclusions: Spontaneously beating cardiomyocytes derived from mESCs showed BRV that appears to be similar to the HRV known from humans. Antiarrhythmic drugs affected BRV parameters similar to clinical observations. Therefore, our study demonstrates that this in vitro model can contribute to a better understanding of electrophysiological properties of mESC-derived cardiomyocytes and might serve as a valuable tool for drug safety screening.

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“…Van Geldcr-Hasker et al [6] reported the effect of fle cainide acetate on fetal heart rate variability. They re…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Supraventricular Tachycardia with Flecainide Acetate: A Case Report

Amano

Harada²,

Shoda³

et al. 1997

Fetal Diagn Ther

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Background: Efficacy of flecainide acetate for the treatment of fetal supraventricular tachycardia with cardiac failure was reported. Case: For a case in which maternal digoxin therapy failed, flecainide acetate (400 mg/day) is used from 27 weeks. Cardioversion with improved cardiac function occurred 6 days after treatment. Fetal serum flecainide acetate level was 292 ng/ml which was 64% of the maternal level (453 ng/ml). No adverse maternal side effects were noted with 11 weeks of therapy. A vigorous male baby, weighing 3,610 g, Apgar 8/9, Ua-pH 7.24, was born. He is now 1 year of age and in good condition with medication of 5 mg/kg flecainide acetate. Conclusion: Flecainide acetate seemed to be safe for both mother and fetus, and effective for the treatment of fetal supraventricular tachycardia which is refractory to transplacental digoxin therapy.

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The effect of flecainide acetate on fetal heart rate variability: A case report

Abstract: Flecainide use can cause the absence of accelerations and poor variability in the FHR.

Cited by 10 publications

References 7 publications

Effect of Prenatal Antiarrhythmic Treatment on Cardiac Function in a Twin Pregnancy

Effect of Prenatal Antiarrhythmic Treatment on Cardiac Function in a Twin Pregnancy

Beat Rate Variability in Murine Embryonic Stem Cell-Derived Cardiomyocytes: Effect of Antiarrhythmic Drugs

Successful Treatment of Supraventricular Tachycardia with Flecainide Acetate: A Case Report

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