Transplacental Cardioversion of Fetal Supra Ventricular Tachycardia with Procainamide

Dumesic, Daniel A.; Silverman, Norman H.; Tobias, Serge; Golbus, Mitchell S.

doi:10.1056/nejm198210283071806

Cited by 78 publications

(16 citation statements)

References 19 publications

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“…Whereas there have been a number of reports of successful fetal cardioversion by administration of various medications via the mother, with digitalis being the most commonly used (Dumesic et al, 1982;Harrigan et al, 1981;Kerenyi et al, 1980). we failed to cardiovert three cases of tachydysrbythmia.…”

Section: Commentsmentioning

confidence: 77%

Fetal cardiac structure and function as studied by ultrasound

Wladimiroff

Stewart

Vosters

1984

Clinical Cardiology

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Summary: Present combined two-dimensional real-time and M-mode echocardiograph systems allow detailed analysis of fetal cardiac structure and function. Standard scanning planes for systematic investigation of various cardiac structures are described. There is a curvilinear increase in left ventricular volume (Qlv), stroke volume (Qlvs), and output Q'lv) during the last trimester of pregnancy with a mean Q'lv value at term of 126± 11 mI/kg/min. Scanning for cardiac defects should preferably be done between 18 and 24 weeks of gestation. In a total of 444 patients referred to our ultrasound unit for ultrasonic analysis of fetal cardiac structure, a total of 13 cardiac defects were diagnosed. The incidence of structural cardiac defects present among those with fetal dysrllythmia was 15%.

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Section: Commentsmentioning

confidence: 77%

Fetal cardiac structure and function as studied by ultrasound

Wladimiroff

Stewart

Vosters

1984

Clinical Cardiology

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“…On the one hand, when the latter antiarrhythmic agents are used, undesirable effects in the fetus may occur, particularly with already existing cardiac insufficiency due to the negative inotropic effects of some of these antiarrhythmic agents. It is still relatively unclear whether and to what extent these drugs cross the placenta [1,2,5,11,12,13].…”

Section: Discussionmentioning

confidence: 99%

Intrauterine therapy of fetal tachyarrhythmias: Intraperitoneal administration of antiarrhythmic drugs to the fetus in fetal tachyarrhythmias with severe hydrops fetalis

Gembruch

Hansmann²,

Redel³

et al. 1988

Journal of Perinatal Medicine

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“…Several successful cases of in utero car dioversion for fetal supraventricular tachy cardia using procainamide have been re ported [2]. In our first case, the blood flow pattern in the descending aorta indicated that supraventricular tachycardia was converted with procainamide not gradually but sud denly as in an adult.…”

Section: Discussionmentioning

confidence: 72%

Hemodynamic Changes during Cardioversion in utero: A Case Report of Supraventricular Tachycardia and Atrial Flutter

et al. 1993

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Two cases of fetal tachyarrhythmias were treated in utero. One case showed supraventricular tachycardia which was successfully treated with procainamide. The other case was an atrial flutter with 2:1 atrioventricular conduction (AVC) which was treated with digoxin and verapamil. In both cases, the blood flow in the descending aorta was observed using pulsed Doppler ultrasound during therapy. In the first case, the interval of blood flow peaks was suddenly prolonged to normal heart rate, and in the second case, the blood flow peaks appeared irregularly which indicated that (AVC) was intermittently blocked. The blood flow pattern represented the mode of cardioversion. The blood flow velocity was also measured in both cases; it decreased transiently during therapy representing a depression in cardiac function. The cause of this was thought to be the negative inotropic effects of procainamide and verapamil. In spite of these negative inotropic effects, a greater R-R interval means a greater stroke volume. This relationship has a favorable effect on the fetal circulation as a result of therapy for fetal tachyarrhythmias.

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Transplacental Cardioversion of Fetal Supra Ventricular Tachycardia with Procainamide

Cited by 78 publications

References 19 publications

Fetal cardiac structure and function as studied by ultrasound

Fetal cardiac structure and function as studied by ultrasound

Intrauterine therapy of fetal tachyarrhythmias: Intraperitoneal administration of antiarrhythmic drugs to the fetus in fetal tachyarrhythmias with severe hydrops fetalis

Hemodynamic Changes during Cardioversion in utero: A Case Report of Supraventricular Tachycardia and Atrial Flutter

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